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超声引导下腰方肌外侧阻滞对开放性肾切除术患者术后疼痛及恢复质量的疗效:一项随机对照研究。

Efficacy of ultrasound-guided lateral quadratus lumborum block on postoperative pain and quality of recovery in patients undergoing open nephrectomy: A randomized controlled study.

作者信息

Yağbasan Büşra, Özdemir Levent

机构信息

Department of Anesthesiology and Intensive Care, Mersin University School of Medicine, Mersin, Turkiye.

出版信息

Medicine (Baltimore). 2025 Sep 12;104(37):e44397. doi: 10.1097/MD.0000000000044397.

DOI:10.1097/MD.0000000000044397
PMID:40958255
Abstract

BACKGROUND

In our study, we aimed to evaluate the effects of lateral quadratus lumborum block (QLB) on postoperative pain and quality of recovery (QoR) in patients undergoing open nephrectomy.

METHODS

This study was designed as a randomized, prospective study. Patients were divided into 2 groups as lateral QLB group (group QLB) and Morphine group (group M). Lateral QLB was applied to patients in the QLB group with 25 mL of 0.25% bupivacaine. Opioid consumption, visual analog scale (VAS) and QoR-15 scores of the patients in the first 72 hours postoperatively were recorded.

RESULTS

A total of 40 patients were included in the study (group QLB, n = 20 and group M, n = 20). No significant difference was observed in total morphine consumption. VAS pain scores were lower in the lateral QLB group at postoperative 0th min, 30th min, 2nd, 3rd, 12th and 48th hour (P < .05). Postoperative agitation was significantly less in patients who underwent lateral QLB (P = .01). Length of hospital stay was shorter in the QLB group (P = .02). QoR-15 score was higher in lateral QLB group only on the 3rd postoperative day (P = .02).

CONCLUSION

In patients undergoing open nephrectomy, lateral QLB may be a safe part of multimodal analgesia because it reduces postoperative pain scores, agitation and length of hospital stay. However, it should be noted that in our study, no significant difference was found between the groups in terms of total morphine consumption and QoR.

摘要

背景

在我们的研究中,旨在评估腰方肌外侧阻滞(QLB)对接受开放性肾切除术患者术后疼痛及恢复质量(QoR)的影响。

方法

本研究设计为一项随机、前瞻性研究。患者被分为两组,即腰方肌外侧阻滞组(QLB组)和吗啡组(M组)。QLB组患者接受25毫升0.25%布比卡因的腰方肌外侧阻滞。记录患者术后前72小时的阿片类药物消耗量、视觉模拟评分(VAS)和QoR-15评分。

结果

本研究共纳入40例患者(QLB组,n = 20;M组,n = 20)。总吗啡消耗量未见显著差异。术后第0分钟、30分钟、第2、3、12和48小时,腰方肌外侧阻滞组的VAS疼痛评分较低(P <.05)。接受腰方肌外侧阻滞的患者术后躁动明显较少(P =.01)。QLB组的住院时间较短(P =.02)。仅在术后第3天,腰方肌外侧阻滞组的QoR-15评分较高(P =.02)。

结论

对于接受开放性肾切除术的患者,腰方肌外侧阻滞可能是多模式镇痛的安全组成部分,因为它可降低术后疼痛评分、减少躁动并缩短住院时间。然而,应注意的是,在我们的研究中,两组在总吗啡消耗量和恢复质量方面未发现显著差异。

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