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后路竖脊肌平面阻滞用于髋关节手术后患者的术后镇痛效果:系统评价和荟萃分析。

Postoperative analgesic effectiveness of quadratus lumborum block: systematic review and meta-analysis for adult patients undergoing hip surgery.

机构信息

Department of Orthopedics, Chongqing General Hospital, Chongqing, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147, People's Republic of China.

出版信息

J Orthop Surg Res. 2022 May 19;17(1):282. doi: 10.1186/s13018-022-03172-8.

Abstract

BACKGROUND

Quadratus lumborum block is a truncal block with several technique variations. It has been reported as providing effective analgesia for postoperative pain. The aim of this study is to determine the efficacy of the QL block in providing postoperative analgesia for hip surgery when compared with placebo or no block or other analgesic techniques.

METHODS

Randomized trials evaluating quadratus lumborum block benefits in elective hip surgery were sought. The primary outcome was the 24 h opioid requirement after surgery. Two independent reviewers selected the studies and extracted the data.

RESULTS

Thirteen randomized-controlled trials were included in this study. The included studies had significant heterogeneity regarding comparator groups; therefore, a limited quantitative analysis was undertaken for the comparison of QL block versus no block or placebo only. QL block reduced the opioid use by 15.78 (95% CI, 2.31 to 29.26) mg IME in the first postoperative 24 h compared with no block or placebo with no difference in static pain scores, pain grade was reduced by 2.95 (95% CI, 2.40 to 3.60) in the QL block group compared with placebo or no block in the first postoperative 24 h during movement.

CONCLUSIONS

Our meta-analysis indicates that QL block may be effective for analgesia in patients after hip surgery compared with placebo or no block. There is currently limited evidence comparing QL block with other analgesic techniques for hip surgery.

摘要

背景

竖脊肌阻滞是一种具有多种技术变化的躯干阻滞。它已被报道为提供有效的术后疼痛缓解。本研究的目的是确定 QL 阻滞在髋部手术中提供术后镇痛的效果,与安慰剂或无阻滞或其他镇痛技术相比。

方法

寻找评估竖脊肌阻滞对择期髋关节手术益处的随机试验。主要结局是术后 24 小时内的阿片类药物需求。两名独立的审查员选择研究并提取数据。

结果

本研究纳入了 13 项随机对照试验。纳入的研究在对照组方面存在显著的异质性;因此,仅对 QL 阻滞与无阻滞或安慰剂进行了有限的定量分析。与无阻滞或安慰剂相比,QL 阻滞在术后前 24 小时内减少了 15.78 毫克 IME 的阿片类药物使用(95%置信区间,2.31 至 29.26),在术后前 24 小时内,与安慰剂或无阻滞相比,静息疼痛评分无差异,但在运动时,QL 阻滞组的疼痛等级降低了 2.95(95%置信区间,2.40 至 3.60)。

结论

我们的荟萃分析表明,与安慰剂或无阻滞相比,QL 阻滞可能对髋部手术后患者的镇痛有效。目前,比较 QL 阻滞与髋部手术其他镇痛技术的证据有限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ba0/9118859/9faff53bd6a6/13018_2022_3172_Fig1_HTML.jpg

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