Comparative research on effects of different approaches of quadratus lumbar block under the guidance of ultrasound on postoperative analgesia of patients with femoral head necrosis
10.3969/j.issn.1672-8270.2024.05.017
- VernacularTitle:超声引导下不同入路腰方肌阻滞在股骨头坏死患者术后镇痛中的效果研究
- Author:
Li ZHANG
1
;
Ying ZHANG
;
Liping WANG
Author Information
1. 唐山市第二医院麻醉科 唐山 063000
- Keywords:
Femoral head necrosis;
Hip catheterization;
Degree of pain;
Quadratus lumbar block(QLB)
- From:
China Medical Equipment
2024;21(5):88-91
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the application effect of three different approaches of quadratus lumbar block(QLB)under the guidance of ultrasound in postoperative analgesia of patients with femoral head necrosis.Methods:A total of 120 patients with femoral head necrosis who admitted to the Second Hospital of Tangshan from May 2019 to May 2021 were selected.According to dynamic randomization grouping method,they were divided into lateral lumbar quadratus group,posterior lumbar quadratus group and anterior lumbar quadratus group as three different approaches of QLB analgesia,with 40 cases in each group.All patients were treated with hip catheterization,and the lateral,posterior and anterior QLB analgesia methods were performed after surgery.The visual analogue scale(VAS)scores of the three groups were compared before analgesia and at the 1st,6th and 12th h after analgesia,and the incidences of adverse reactions among the three groups after medication were compared.Results:The analysis of generalized estimation equation showed that the VAS scores of the three groups appeared a decreasing trend from 1h after analgesia to 12h after analgesia,and they were respectively 3.83(3.51,4.01)points,3.15(2.99,3.43)points,3.25(3.08,3.53)points vs.3.18(3.03,3.50)points,2.80(2.65,2.95)points,2.80(2.55,2.97)points.There was statistical significant difference in VAS scores among different time points within the group(Wald x2=2 778.131,P<0.05).The VAS scores at different time points after analgesia in posterior approaches group and anterior approaches group were lower than those in lateral approaches group(Wald x2=102.935,P<0.05).The decrease trend of VAS scores after analgesia in posterior approaches group and anterior approaches was larger than that in lateral approaches group,which meant that the analgesic effect of anterior approaches and posterior approaches of lumbar quadratus was stronger than that of lateral approach of lumbar quadratus(Wald x2=25.245,P<0.05).Conclusion:The postoperative analgesic effect of ultrasound-guided QLB by adopting anterior and posterior approaches of lumbar quadratus muscle is significantly higher than that by adopting lateral approach of lumbar quadratus muscle in patients with femoral head necrosis.There is no significant difference in adverse reactions of undergoing QLB analgesia under three different approaches.
