关键词:

腰方肌阻滞, 腹腔镜手术, 超声引导, 术后疼痛

Abstract:

Objective　To explore the effect of ultrasound-guided quadratus lumborum block (QLB) in laparoscopic and colorectal surgery and its influence on the scores of Visual Analogue Scale (VAS) 4, 6, 12, and 24 h after surgery. Methods　One hundred and twenty-one patients undergoing laparoscopic and colorectal surgery at First Hospital, Nanyang Medical College from October 2020 to July 2022 were selected as the research objects for prospective study. After analyzing the patients' medical records, the patients were divided into an observation group (61 cases) and a control group (60 cases) according to the different anesthesia schemes. There were 34 males and 27 females in the observation group who were (51.27±3.49) years old. There were 32 males and 28 females in the control group who were (51.52±3.13) years old. The observation group received QLB, and the control group received transverse abdominal muscle block (TAP). The VAS scores of incision pain and visceral pain 4, 6, 12, and 24 h after the operation, block-related indicators, and adverse reactions were compared between the two groups. t and χ² tests were applied. Results　There were no statistical differences in the amounts of fluid and blood loss between the two groups (both P>0.05). While the intraoperative dosages of sufentanil and remifentanil were the same, the total consumptions of sufentanil and remifentanil in the observation group were significantly lower than those in the control group [(185.74±13.32) μg vs. (204.37±13.67) μg and (947.42±82.25) μg vs. (1 525.28±125.34) μg], with statistical differences (t=7.593 and 30.030; both P<0.05). The incidence of adverse reactions during analgesia in the observation group was lower than that in the control group [3.28% (2/61) vs. 15.00% (9/60)], with a statistical difference (χ²=5.028, P=0.025). There were no statistical differences in the VAS scores of incision pain after the operation between the two groups (all P>0.05). The VAS scores of visceral pain 4, 6, 12, and 24 h after the operation in the observation group were lower than those in the control group [(1.79±0.11) vs. (5.83±0.51), (1.58±0.11) vs. (5.64±0.53), (1.54±0.13) vs. (4.55±0.40), and (1.31±0.10) vs. (3.91±0.38)], with statistical differences (t=60.460, 58.565, 55.853, and 37.350; all P<0.05). Conclusion　QLB has a significant clinical effect in laparoscopic colorectal surgery, and can effectively improve postoperative visceral pain scores and reduce the dosage of analgesics and adverse reactions, so it is worthy of clinical promotion.

Key words:

Quadratus lumbar muscle block, Laparoscopic colorectal surgery, Ultrasound-guided, Postoperative pain