Yuan Liangjing, Xu Chengshi, Zhang Ye, Wang Geng
Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing 100000, China.
J Hip Preserv Surg. 2022 Mar 29;9(2):119-125. doi: 10.1093/jhps/hnac020. eCollection 2022 Jul.
Controlled trials assessing quadratus lumborum block (QLB) for post-operative analgesia in hip surgery are scarce. This study aimed to compare ultrasound-guided QLB and lumbar plexus block (LPB) for clinical efficacy in hip arthroscopy. Patients undergoing hip arthroscopy in Beijing Jishuitan Hospital in January-June 2019 were randomized to the lumbar plexus (L) and quadratus lumborum (Q) groups ( = 25/group). After either ultrasound-guided block for 30 min, both groups were prepared for surgery after muscle strength measurement in the affected limbs. Opioid doses for patient-controlled analgesia (PCA), visual analog scale (VAS) scores in the resting and active states, upon leaving the post-anesthesia care unit (PACU), and at 2-48 h post-surgery were recorded, and post-operative complications were also recorded. Muscle strength in the affected limbs was significantly higher in the Q group compared with the L group (4.0 versus 2.0, < 0.001). VAS scores were similar in both groups post-surgery ( > 0.05). One patient had epidural spread in the L group, with no other complications. Compared with ultrasound-guided LPB, ultrasound-guided QLB provides similar and good post-operative analgesia after hip arthroscopy, with less impact on muscle strength and fewer complications. These results should be confirmed in larger trials.
评估腰方肌阻滞(QLB)用于髋关节手术术后镇痛的对照试验很少。本研究旨在比较超声引导下QLB和腰丛阻滞(LPB)在髋关节镜手术中的临床疗效。2019年1月至6月在北京积水潭医院接受髋关节镜手术的患者被随机分为腰丛(L)组和腰方肌(Q)组(每组 = 25例)。在超声引导下阻滞30分钟后,两组均在测量患侧肢体肌力后准备手术。记录患者自控镇痛(PCA)的阿片类药物剂量、离开麻醉后监护病房(PACU)时以及术后2 - 48小时静息和活动状态下的视觉模拟评分(VAS),并记录术后并发症。与L组相比,Q组患侧肢体肌力明显更高(4.0对2.0,<0.001)。两组术后VAS评分相似(>0.05)。L组有1例出现硬膜外扩散,无其他并发症。与超声引导下LPB相比,超声引导下QLB在髋关节镜手术后提供相似且良好的术后镇痛效果,对肌力影响较小且并发症较少。这些结果应在更大规模的试验中得到证实。