Application effects of different doses of bupivacaine liposome in posterior quadratus lumborum block for post-operative analgesia after cesarean section
- VernacularTitle:不同剂量布比卡因脂质体用于后路腰方肌阻滞在剖宫产术后镇痛中的应用效果
- Author:
Lan CHEN
1
;
Yiping BAI
2
;
Yanhong XIE
3
;
Junyue CHEN
3
;
Jing YANG
3
Author Information
1. Dept. of Anesthesiology，the Affiliated Hospital，Southwest Medical University，Sichuan Luzhou 646000，China;Dept. of Anesthesiology，Chongzhou Maternal and Child Health Hospital，Sichuan Chongzhou 611230，China
2. Dept. of Anesthesiology，the Affiliated Hospital，Southwest Medical University，Sichuan Luzhou 646000，China;Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou，Sichuan Luzhou 646000，China
3. Dept. of Anesthesiology，Chongzhou Maternal and Child Health Hospital，Sichuan Chongzhou 611230，China
- Publication Type:Journal Article
- Keywords:
bupivacaine liposome;
posterior quadratus lumborum block;
cesarean section;
postoperative analgesia
- From:
China Pharmacy
2025;36(18):2291-2296
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the efficacy and safety of different doses of bupivacaine liposome （referred to as “LB”） in posterior quadratus lumborum block （QLB） for postoperative analgesia in patients undergoing cesarean section （CS）. METHODS In prospective research method， a total of 168 patients undergoing CS admitted to Chongzhou Maternal and Child Health Hospital from June to December 2024 were randomly divided into LB1 group， LB2 group， and LB3 group （LB of 199， 133 and 67 mg， respectively） according to the random number sorting method， with 56 cases in each group. All patients underwent CS after combined spinal-epidural anesthesia， and received patient-controlled intravenous analgesia and bilateral posterior QLB with different doses of LB after the operation. Visual analogue scale score， Ramsay sedation score， the presence of postoperative block planes and muscle strength classification were observed in the three groups of patients at 6， 12， 24， 48 and 72 hours after the operation. The time of the first compression of the analgesic pump， the dosage of sufentanil and butorphanol within 72 hours after surgery， the number of compressions of the analgesic pump， the analgesic rescue rate， the time of initiating lactation， the score of neonatal behavioral neurological assessment （NBNA）， the time of postoperative exhaust， the indwelling time of urinary catheter， the length of hospital stay， and the total satisfaction at 72 hours after surgery were compared. The occurrence of adverse reactions within 72 hours after the operation was recorded. RESULTS The resting and motor pain scores， the dosage of sufentanil and butorphanol within 72 hours after surgery， the number of compressions of the analgesic pump， the analgesic rescue rate， and the time of initiating lactation at 6， 12， 24， 48 and 72 hours after surgery in the LB1 group and the LB2 group were significantly lower or shorter than those in the LB3 group（P＜0.05）. The proportion of postoperative block planes at 24， 48 and 72 hours after surgery， the time of the first compression of the analgesic pump and the total satisfaction in the LB1 group and the LB2 group were significantly higher or longer than those in the LB3 group（P＜0.05）. The proportion of patients with muscle strength≤grade 3 at 6 hours after surgery in the LB1 group was significantly higher than that in the LB2 and the LB3 groups （P＜0.05）. There were no statistically significant differences in the Ramsay sedation scores at each time point after surgery， NBNA scores， postoperative exhaust time， urinary catheter indwelling time， the length of hospital stay， as well as the occurrence of adverse reactions among the 3 groups （P＞0.05）. CONCLUSIONS Compared with 67 mg of LB， 199 mg and 133 mg of LB can improve the postoperative analgesic effect and total satisfaction of CS patients undergoing posterior QLB， reduce the use of postoperative analgesic drugs， and shorten the time to start lactation. Compared with 199 mg and 133 mg of LB， 67 mg of LB has a smaller impact on the motor function of CS patients. All three doses of LB had no significant effect on the neurobehavioral abilities of newborns, and demonstrated comparable sedative efficacy and safety.
