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肾移植手术中给供体和受体进行腰方肌前阻滞与静脉注射镇痛药的术后镇痛效果:一项前瞻性队列研究。

Postoperative Analgesic Effects of Anterior Quadratus Lumborum Block vs Intravenous Analgesics Administered to Donors and Recipients in Renal Transplantation Surgery: A Prospective Cohort Study.

作者信息

Acil Fatma, Dedeoğlu Andaç, Yürekli Ali İhsan, Tosun Söner Hülya, Uzundere Osman, Danış Ramazan, Ay Nurettin, Kaçar Cem Kıvılcım, Gökçek Erhan, Kaya Sedat

机构信息

Department of Anesthesiology and Reanimation, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

Department of Internal Diseases and Nephrology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

出版信息

Ann Transplant. 2025 Sep 9;30:e949037. doi: 10.12659/AOT.949037.

Abstract

BACKGROUND Among the limited analgesic options, plane blocks are of great importance in providing effective postoperative analgesia to donors and recipients in renal transplantation surgery. We aimed to demonstrate that anterior type quadratus lumborum plane block provides better analgesia than intravenous paracetamol in open and closed nephrectomy patients. MATERIAL AND METHODS We conducted a prospective cohort study. Renal recipients and donors were divided into 2 groups. One group received anterior quadratus lumborum plane block and the other group received intravenous paracetamol. Pain levels and total tramadol consumption at 1, 2, 6, 12, and 24 hours postoperatively were recorded as primary data. RESULTS Demographic data of donors and recipients were similar between the QLB and IVA groups, and there was no significant difference in the time spent for surgery, anesthesia, or hospitalization. In renal donors, we found that total tramadol consumption and pain scores of the quadratus lumborum block group were significantly lower than in the intravenous analgesia group (P<0.001). In renal recipients, we found that postoperative tramadol consumption and pain levels of the quadratus lumborum block group were significantly lower than in the intravenous analgesia group (P<0.001). Additionally, the duration of rescue analgesic requirement was significantly shorter in renal recipients and donors who underwent quadratus lumborum plane block compared to the intravenous analgesic group (P<0.001). CONCLUSIONS The anterior type quadratus lumborum plane block provides effective analgesia to recipients and donors in renal transplantation surgery and reduces postoperative opioid consumption.

摘要

背景 在有限的镇痛选择中,平面阻滞对于为肾移植手术的供体和受体提供有效的术后镇痛非常重要。我们旨在证明,在开放和闭合性肾切除术患者中,前路腰方肌平面阻滞比静脉注射对乙酰氨基酚提供更好的镇痛效果。

材料与方法 我们进行了一项前瞻性队列研究。肾移植受体和供体被分为两组。一组接受前路腰方肌平面阻滞,另一组接受静脉注射对乙酰氨基酚。术后1、2、6、12和24小时的疼痛程度和曲马多总消耗量被记录为主要数据。

结果 腰方肌平面阻滞组(QLB)和静脉注射对乙酰氨基酚组(IVA)的供体和受体的人口统计学数据相似,手术、麻醉或住院时间没有显著差异。在肾供体中,我们发现腰方肌阻滞组的曲马多总消耗量和疼痛评分显著低于静脉镇痛组(P<0.001)。在肾受体中,我们发现腰方肌阻滞组的术后曲马多消耗量和疼痛程度显著低于静脉镇痛组(P<0.001)。此外,与静脉镇痛组相比,接受腰方肌平面阻滞的肾受体和供体的补救镇痛需求持续时间显著缩短(P<0.001)。

结论 前路腰方肌平面阻滞为肾移植手术的受体和供体提供有效的镇痛,并减少术后阿片类药物的消耗。

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