Altınay Mustafa, Türk Hacer Şebnem
University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2023 Oct 24;51(5):443-449. doi: 10.4274/TJAR.2023.231289.
To compare the postoperative analgesic efficacy of quadratus lumborum block (QLB) and ilioinguinal-iliohypogastric nerve block (IIIHB) in paediatric patients who have undergone unilateral inguinal hernia surgery.
This prospective randomized controlled study was designed in a single center and included 60 paediatric patients aged 2-7 years who had undergone inguinal hernia repair surgery and received an American Society of Anesthesiologists score of 1-2. Patients were randomized into two groups: those receiving ultrasound-guided QLB and those receiving IIIHB. The primary outcomes of the study were patients' face, legs, activity, cry, and consolability (FLACC) scores at 1, 2, 6, 12, and 24 hours post-surgery.
The mean heart rate 15 and 30 minutes post-surgery in the QLB group was lower than that of the IIIHB group, and the difference at both times was statistically significant ( < 0.001). The mean FLACC score of the QLB group was lower than that of the IIIHB group at 6, 12, and 24 hours post-surgery, and the differences were statistically significant (=0.004, =0.006, and < 0.001, respectively). Between the groups, there was no statistically significant difference in the number of patients who were administered rescue analgesics or oral ibuprofen, the time of first ibuprofen administration, or the frequency of complications (=1.000, =0.145, =0.195, and =1.000, respectively).
Compared with IIIHB, QLB achieves superior postoperative analgesic effects in paediatric patients who have undergone inguinal hernia surgery, as evidenced by longer analgesic periods, lower pain scores, and lower analgesic consumption.
比较腰方肌阻滞(QLB)和髂腹股沟-髂腹下神经阻滞(IIIHB)在接受单侧腹股沟疝手术的儿科患者中的术后镇痛效果。
本前瞻性随机对照研究在单一中心进行,纳入60例年龄在2至7岁、接受腹股沟疝修补手术且美国麻醉医师协会评分为1至2分的儿科患者。患者被随机分为两组:接受超声引导下QLB的患者和接受IIIHB的患者。本研究的主要结局指标为术后1、2、6、12和24小时患者的面部、腿部、活动、哭闹及安慰情况(FLACC)评分。
QLB组术后15分钟和30分钟的平均心率低于IIIHB组,且这两个时间点的差异均具有统计学意义(<0.001)。QLB组术后6、12和24小时的平均FLACC评分低于IIIHB组,差异具有统计学意义(分别为=0.004、=0.006和<0.001)。两组之间,在接受补救性镇痛药或口服布洛芬的患者数量、首次服用布洛芬的时间或并发症发生率方面无统计学显著差异(分别为=1.000、=0.145、=0.195和=1.000)。
与IIIHB相比,QLB在接受腹股沟疝手术的儿科患者中具有更优的术后镇痛效果,表现为镇痛时间更长、疼痛评分更低和镇痛药消耗量更低。