Comparison of quadratus lumborum block at supra-arcuate ligament and erector spinae block on postoperative analgesia and recovery quality in patients undergoing thoracoscopic surgery
10.3969/j.issn.1671-8348.2024.21.005
- VernacularTitle:弓状韧带上腰方肌阻滞与竖脊肌阻滞对胸腔镜手术患者术后镇痛及恢复质量的比较
- Author:
Lingzhi WANG
1
;
Ruifen ZHOU
;
Qilu YING
;
Manhua ZHU
Author Information
1. 宁波大学附属李惠利医院麻醉科,浙江宁波 315040
- Keywords:
arcuate ligament;
quadratus lumborum block;
erector spinae plane block;
thoracoscopic sur-gery;
analgesia
- From:
Chongqing Medicine
2024;53(21):3222-3227
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of quadratus lumborum block at supra-arcuate ligament(SA-QLB)and erector spinae plane block(ESPB)on postoperative analgesia and recovery quality in the pa-tients undergoing thoracoscopic surgery.Methods Sixty patients undergoing elective thoracoscopic surgery,aged 18-70 years old,ASA grade Ⅰ-Ⅱ,served as the study subjects and were randomly divided into the two groups by the random number table method:SA-QLB group(group Q,n=30)and ESPB(group E,n=30).Before induction of general anesthesia,the group Q conducted SA-QLB in the operation side under the ultra-sound guide and the group E conducted ESPB,the both were given 30 mL of 0.25％ropivacaine.All patients in both groups were given the patient-controlled intravenous analgesia(PCIA)after surgery.The dosage of remifentanil during surgery,recovery time,Visual Analogue Scale(VAS)score at rest and cough at 1,6,12,24,48 h after surgery,first pressing time of patient-controlled analgesia,times of effective pressing,dosage of sufentanil and number of cases of rescue analgesia at 24 h after surgery,forced vital capacity(FVC)and forced expiratory volume first second(FEV1)at 1 h before surgery and 24 h after surgery,scores of quality recovery at postoperative 24 h(QoR-15)and Barthel score,hospitalization duration after operation and the occurrence of adverse reactions were recorded.Results Compared with the group E,the intraoperative remifentanil dos-age in the group Q was decreased(P＜0.05);the VAS scores in rest and cough at postoperative 6,12,24 h were decreased(P＜0.05);the first pressing time of postoperative analgesia pump in the group Q was pro-longed,number of effective pressures of analgesia pump,dosage of sufentanil and cases number of remedy an-algesia were decreased(P＜0.05);FEV1 and FVC at postoperative 24 h in the group Q were significantly in-creased(P＜0.05);the scores of QoR-15 and Barthel at postoperative 24 h were increased(P＜0.05).The in-cidence rates of postoperative nausea and vomiting in the group Q were lower than those in the group E(P＜0.05),and no serious adverse events occurred in the two groups.Conclusion Compared with ESPB,SA-QLB could provide more perfect postoperative analgesia effect,which is conducive to postoperative early pulmonary function recovery,and the postoperative recovery quality is higher.
