Bai He, Zhong Shuting, Yang Xiaomei, Hou Lili, Liu Qianqian, Wang Yanan, Wang Zhou, Sun Baozhu
Department of Anesthesiology, Qilu Hospital of Shandong University, Shandong University, 107# Wenhua Xi Road, Jinan, Shandong, 250012, China.
Department of Physical Examination, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
BMC Anesthesiol. 2025 Jul 30;25(1):365. doi: 10.1186/s12871-025-03230-8.
Lateral quadratus lumborum block (QLB) and transversus abdominis plane block (TAPB) have been widely used in abdominal surgeries. This study aimed to compare the intraoperative analgesic effect, hemodynamic changes and postoperative complications of the two blocks in patients undergoing laparoscopic colorectal cancer surgery.
This was a randomized controlled trial that enrolled 189 patients scheduled for laparoscopic colorectal cancer surgery. Patients were randomly allocated into three groups: the QL group ( = 63) received bilateral ultrasound-guided lateral QLB; the TAP group ( = 63) received bilateral ultrasound-guided TAP block; and the GA group ( = 63) received no blocks. The primary outcome was cumulative remifentanil administration during laparoscopic colorectal cancer surgeries. Secondary outcomes included intraoperative hemodynamics (mean arterial pressure and heart rate), postoperative pain intensity, length of hospital stay and postoperative complications.
One hundred eighty-four patients were eventually enrolled in the study. Intraoperative remifentanil administration was significantly lower in the QL group (398.69 ± 169.07 µg) than the TAP group (477.25 ± 156.55 µg) and the GA group (493.25 ± 195.32 µg) ( < 0.05), and there was no significant difference between the TAP group and the GA group ( > 0.05). At pneumoperitoneum establishment and abdominal incision time point, the MAP values of the GA group (98.59 ± 14.18 mmHg and 87.57 ± 12.03 mmHg, respectively) were significantly higher than in the TAP group and the QL group (91.18 ± 15.61 mmHg; 92.30 ± 11.91 mmHg and 80.95 ± 12.06 mmHg; 82.49 ± 10.99 mmHg, respectively) ( < 0.05). VAS scores at 15 min and 6 h after surgery were significantly lower in the QL group and the TAP group than in the GA group ( < 0.05).
In patients undergoing laparoscopic colorectal cancer surgery, the lateral QL block was superior than the TAP block in reducing intraoperative remifentanil usage. However, both blocks could provide greater intraoperative hemodynamic stability and better perioperative analgesia.
The online version contains supplementary material available at 10.1186/s12871-025-03230-8.
腰方肌外侧阻滞（QLB）和腹横肌平面阻滞（TAPB）已广泛应用于腹部手术。本研究旨在比较这两种阻滞方法在腹腔镜结直肠癌手术患者中的术中镇痛效果、血流动力学变化及术后并发症。
这是一项随机对照试验，纳入189例计划行腹腔镜结直肠癌手术的患者。患者被随机分为三组：QL组（n = 63）接受双侧超声引导下腰方肌外侧阻滞；TAP组（n = 63）接受双侧超声引导下腹横肌平面阻滞；GA组（n = 63）不接受任何阻滞。主要结局指标为腹腔镜结直肠癌手术期间瑞芬太尼的累计用量。次要结局指标包括术中血流动力学（平均动脉压和心率）、术后疼痛强度住院时间及术后并发症。
最终184例患者纳入研究。QL组术中瑞芬太尼用量（398.69±169.07μg）显著低于TAP组（477.25±156.55μg）和GA组（493.25±195.32μg）（P < 0.05），TAP组与GA组之间无显著差异（P > 0.05）。在气腹建立和腹部切口时间点，GA组的平均动脉压值（分别为98.59±14.18 mmHg和87.57±12.03 mmHg）显著高于TAP组和QL组（分别为91.18±15.61 mmHg；92.30±11.91 mmHg和80.95±12.06 mmHg；82.49±10.99 mmHg）（P < 0.05）。术后15分钟和6小时时，QL组和TAP组的视觉模拟评分（VAS）显著低于GA组（P < 0.05）。
在腹腔镜结直肠癌手术患者中，腰方肌外侧阻滞在减少术中瑞芬太尼用量方面优于腹横肌平面阻滞。然而，两种阻滞方法均可提供更好的术中血流动力学稳定性和围手术期镇痛效果。
在线版本包含可在10.1186/s12871-025-03230-8获取的补充材料。
