Shariat Ali, Kadakia Rishi, Lin Hung-Mo, Egorova Natalia, Jin Shirley, Latmore Malikah, Epstein Jonathan, Pai B H Poonam, Park Koji, Kini Subhash, Bhatt Himani V
Icahn School of Medicine at Mount Sinai, New York, United States.
University of California, San Francisco, San Francisco, United States.
Obes Surg. 2025 May 22. doi: 10.1007/s11695-025-07934-1.
We are studying whether the performance of the posterior quadratus lumborum block (pQLB) will decrease postoperative opioid consumption in patients undergoing laparoscopic sleeve gastrectomy (LSG) compared with surgical wound infiltration with local anesthetic.
This is a single-center, prospective, randomized pilot study. Forty ASA 3 patients with severe obesity undergoing LSG were randomized to receive either the pQLB or surgical wound infiltration of local anesthetics. Major endpoints included postoperative analgesic medications in the pQLB group versus the surgical wound infiltration group, visual analog pain scores (VAS 0-10), postoperative time to first opioid, and incidence of nausea and vomiting.
Opioid consumption in morphine equivalents on postoperative days 1 (p = 0.86) and 2 (p = 0.57) was not significantly different between the two groups. However, patients in the pQLB group had significantly lower VAS pain scores on postoperative day 1 (p = 0.003) and postoperative day 2 (p = 0.04) than those who received surgical wound infiltration.
This prospective, randomized pilot study shows that the performance of pQLB did not reduce postoperative opioid consumption in patients undergoing LSG. However, patients who received the pQLB had significantly lower postoperative VAS pain scores. Therefore, the performance of pQLB is both feasible and may provide analgesic benefits in patients undergoing LSG.
我们正在研究与局部麻醉剂手术伤口浸润相比，腰方肌后阻滞（pQLB）是否会减少接受腹腔镜袖状胃切除术（LSG）患者的术后阿片类药物消耗。
这是一项单中心、前瞻性、随机试验研究。40例接受LSG的重度肥胖ASA 3级患者被随机分配接受pQLB或局部麻醉剂手术伤口浸润。主要终点包括pQLB组与手术伤口浸润组的术后镇痛药物、视觉模拟疼痛评分（VAS 0 - 10）、术后首次使用阿片类药物的时间以及恶心和呕吐的发生率。
两组术后第1天（p = 0.86）和第2天（p = 0.57）吗啡当量的阿片类药物消耗量无显著差异。然而，pQLB组患者术后第1天（p = 0.003）和第2天（p = 0.04）的VAS疼痛评分显著低于接受手术伤口浸润的患者。
这项前瞻性、随机试验研究表明，pQLB并不能减少接受LSG患者的术后阿片类药物消耗。然而，接受pQLB的患者术后VAS疼痛评分显著更低。因此，pQLB是可行的，并且可能为接受LSG的患者提供镇痛益处。
