Jiang Lingling, Li Yun, Sheng Kui, Zhang Lili, Hu Yang, Zhang Ye
Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei 230601, Anhui Province, China.
Surg Laparosc Endosc Percutan Tech. 2025 Jul 9. doi: 10.1097/SLE.0000000000001392.
A comparative assessment of analgesic effectiveness and recovery quality between the anterior quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) and the transversus abdominis plane block (TAPB) in patients undergoing laparoscopic partial hepatectomy (LPH).
A total of 56 patients scheduled for LPH were randomly allocated to either the QLB-LSAL group or the TAPB group in a 1:1 ratio. Patients in the QLB-LSAL group received bilateral anterior quadratus lumborum block at the lateral supra-arcuate ligament, while those in the TAPB group received bilateral subcostal transversus abdominis plane block before surgery. The primary outcome was the morphine equivalent consumption (MEC) at 24 hours postoperatively. Secondary outcomes included MEC at 48 and 72 hours, as well as numeric rating scale (NRS) pain scores at rest and during movement, recorded at 2, 4, 6, 12, 24, and 48 hours postoperatively. The quality of recovery was assessed using QoR-15 scores, measured 1 day before surgery and on the first and third postoperative days.
The QLB-LSAL group demonstrated significantly lower MEC at 24, 48, and 72 hours postoperatively compared with the TAPB group. NRS scores for pain at rest and during movement were also significantly lower in the QLB-LSAL group at 2, 4, 6, 12, and 24 hours following surgery. In addition, the QoR-15 scores, which assess the quality of recovery, were significantly higher in the QLB-LSAL group compared with the TAPB group on both the first and third postoperative days.
The QLB-LSAL method provides superior analgesia and enhances recovery quality compared with the TAPB approach in patients undergoing LPH.
比较外侧弓形韧带处腰方肌前阻滞（QLB-LSAL）与腹横肌平面阻滞（TAPB）在腹腔镜下肝部分切除术（LPH）患者中的镇痛效果和恢复质量。
总共56例计划行LPH的患者按1:1比例随机分为QLB-LSAL组或TAPB组。QLB-LSAL组患者在外侧弓形韧带处接受双侧腰方肌前阻滞，而TAPB组患者在手术前接受双侧肋下腹横肌平面阻滞。主要结局是术后24小时的吗啡等效用量（MEC）。次要结局包括术后48小时和72小时的MEC，以及术后2、4、6、12、24和48小时记录的静息和活动时的数字评分量表（NRS）疼痛评分。使用QoR-15评分评估恢复质量，在手术前1天以及术后第1天和第3天进行测量。
与TAPB组相比，QLB-LSAL组在术后24、48和72小时的MEC显著更低。术后2、4、6、12和24小时，QLB-LSAL组静息和活动时的NRS疼痛评分也显著更低。此外，在术后第1天和第3天，评估恢复质量的QoR-15评分在QLB-LSAL组显著高于TAPB组。
在接受LPH的患者中，与TAPB方法相比，QLB-LSAL方法提供了更好的镇痛效果并提高了恢复质量。
