Department of Anesthesiology, Xishan People's Hospital of Wuxi City, Wuxi 214105, China.
Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China.
Pain Res Manag. 2022 Apr 30;2022:8994297. doi: 10.1155/2022/8994297. eCollection 2022.
Quadratus lumborum block (QLB) has been used to reduce postoperative acute pain and opioid consumption. However, the efficacy of QLB on the quality of recovery (QoR) after gastrointestinal surgery has not been established. The aim of this study was to evaluate the ability of QLB to enhance the postoperative QoR in patients undergoing open gastrointestinal surgery.
Eighty-four patients undergoing open gastrointestinal surgery were randomized to receive ultrasound-guided QLB with either 20 ml of 0.375% ropivacaine or saline. The primary outcome was the QoR-15 score at 24 h after surgery. The secondary outcomes were the postoperative pain intensity, opioid consumption, the incidence of nausea, vomiting, and chronic pain.
The global QoR-15 score at 24 h postoperatively was significantly higher in the QLB group than in the control group (mean difference: 16.9; 95% CI: 11.9-21.9). Additionally, the QoR-15 scores for five dimensions were significantly higher in the QLB group than in the control group. The cumulative oxycodone consumption was significantly lower in the QLB group during 0-6, 6-24, 0-24, 24-48, and 0-48 h postoperatively than in the control group. At rest or during coughing, the pain verbal rating scale scores were significantly lower at 1, 3, 6, 12, and 24 h after surgery in the QLB group than in the control group. The incidence of postoperative nausea was significantly different between the groups, but postoperative vomiting was not.
Single-injection posteromedial QLB with ropivacaine enhanced the QoR at 48 h after surgery and improved analgesia during the early postoperative period in patients undergoing gastrointestinal surgery.
竖脊肌阻滞（QLB）已被用于减少术后急性疼痛和阿片类药物的消耗。然而，QLB 对胃肠道手术后恢复质量（QoR）的疗效尚未确定。本研究旨在评估 QLB 增强接受胃肠道手术的患者术后 QoR 的能力。
84 例行胃肠道开放手术的患者随机分为接受超声引导的 QLB 治疗的 QLB 组（20ml 0.375%罗哌卡因）或生理盐水的对照组。主要结局是术后 24 小时的 QoR-15 评分。次要结局是术后疼痛强度、阿片类药物消耗、恶心、呕吐和慢性疼痛的发生率。
术后 24 小时，QLB 组的总体 QoR-15 评分显著高于对照组（平均差异：16.9；95%CI：11.9-21.9）。此外，QLB 组的五个维度的 QoR-15 评分均显著高于对照组。在 0-6、6-24、0-24、24-48 和 0-48 小时内，QLB 组的累积羟考酮消耗量显著低于对照组。在休息或咳嗽时，QLB 组术后 1、3、6、12 和 24 小时的疼痛视觉模拟评分均显著低于对照组。两组术后恶心的发生率存在显著差异，但术后呕吐的发生率没有差异。
单次经后内侧 QLB 注射罗哌卡因可增强胃肠道手术后 48 小时的 QoR，并改善术后早期的镇痛效果。
