Wang Wen-Xiu, Zhang Li, Zhou Shu-Zhi, Ran Xin, Zhang Jie
Department of Anesthesiology, Zigong First People Hospital, Zigong, Sichuan, China.
Department of Anesthesiology, Ya'an People Hospital, Ya'an, Sichuan, China.
Front Med (Lausanne). 2025 Aug 29;12:1600630. doi: 10.3389/fmed.2025.1600630. eCollection 2025.
To investigate the effects of different ways of magnesium sulfate injection combined with ultrasound-guided quadratus lumborum block (QLB) on postoperative analgesia and recovery quality of patients undergoing laparoscopic total hysterectomy under general anesthesia.
A total of 88 patients who underwent laparoscopic hysterectomy in Ya'an people's Hospital from June, 2020 to February, 2022, aged from 18 to 65, were randomly divided into three groups: control group (group A, = 29), local magnesium sulfate group (group B, = 29) and intravenous magnesium sulfate group (Group C, = 30) All patients were treated with general anesthesia and patient controlled intravenous analgesia (PCIA) after surgery. General information, visual analogue scale (VAS) at 2 h, 6 h, 12 h, 24 h, 48 h after surgery, dosage of sufentanil in 24 h after surgery, the duration of QLB analgesia (time of first pressing analgesic pump after surgery), 40-item quality of recovery score (QoR-40) before the surgery and on the 3d after surgery, hypotension, bradycardia, postoperative nausea and vomiting (PONV) at 1-3d after surgery, postoperative delirium (POD), skin pruritus, chills, lower limb movement block and other adverse reactions were observed and recorded.
Compared with group A, VAS score and postoperative sufentanil consumption were decreased in group B and group C, and the onset time of first postoperative analgesia request was prolonged ( < 0.05), while there was no statistically significant difference between group B and group C ( > 0.05). The QoR-40 score of group B and group C on 3d after surgery was higher than that of group A ( < 0.05), while there was no statistically significant difference between group B and group C ( > 0.05). The incidence of PONV in group B and group C was lower than that of group A, and the difference was statistically significant ( < 0.05), while there was no statistically significant difference between group B and group C ( > 0.05). No hypotension, bradycardia, POD, pruritus, chills, lower limb movement block were observed.
Intravenous or local use of magnesium sulfate combined with QLB has similar postoperative analgesic effect and promoting postoperative recovery effect in patients undergoing laparoscopic hysterectomy, which can reduce the use of postoperative analgesic drugs, provide effective analgesia and improve the quality of postoperative recovery.
Chinese Clinical Trial Registry (https://www.chictr.org.cn/), identifier ChiCTR2200055978.
探讨不同方式硫酸镁注射联合超声引导下腰方肌阻滞（QLB）对全身麻醉下腹腔镜全子宫切除术患者术后镇痛及恢复质量的影响。
选取2020年6月至2022年2月在雅安市人民医院行腹腔镜子宫切除术的88例患者，年龄18～65岁，随机分为三组：对照组（A组，n = 29）、局部硫酸镁组（B组，n = 29）和静脉硫酸镁组（C组，n = 30）。所有患者均采用全身麻醉，术后行患者自控静脉镇痛（PCIA）。观察并记录患者的一般资料、术后2 h、6 h、12 h、24 h、48 h的视觉模拟评分（VAS）、术后24 h舒芬太尼用量、QLB镇痛持续时间（术后首次按压镇痛泵时间）、术前及术后3 d的40项恢复质量评分（QoR - 40）、术后1～3 d的低血压、心动过缓、术后恶心呕吐（PONV）、术后谵妄（POD）、皮肤瘙痒、寒战、下肢运动阻滞等不良反应。
与A组比较，B组和C组VAS评分及术后舒芬太尼用量降低，术后首次镇痛需求的起效时间延长（P < 0.05），而B组和C组之间差异无统计学意义（P > 0.05）。术后3 d B组和C组的QoR - 40评分高于A组（P < 0.05），而B组和C组之间差异无统计学意义（P > 0.05）。B组和C组PONV发生率低于A组，差异有统计学意义（P < 0.05），而B组和C组之间差异无统计学意义（P > 0.05）。未观察到低血压、心动过缓、POD、瘙痒、寒战、下肢运动阻滞。
静脉或局部使用硫酸镁联合QLB对腹腔镜子宫切除术患者术后镇痛效果及促进术后恢复效果相似，均可减少术后镇痛药物的使用，提供有效镇痛，提高术后恢复质量。
