Quadratus lumborum block combined with less opioid anesthesia analgesia in laparoscopic total hysterectomy in elderly patients with uterine prolapse
10.3760/cma.j.cn115807-20231212-00187
- VernacularTitle:腰方肌阻滞联合少阿片麻醉镇痛在老年子宫脱垂患者腹腔镜全子宫切除术中的应用效果
- Author:
Meilin AN
1
;
Guixiang GUO
;
Lei ZHANG
;
Yu LI
;
Fuyu TIAN
;
Xinli HUANG
;
Dongfeng MA
Author Information
1. 廊坊市人民医院麻醉科，廊坊 065000
- Publication Type:Journal Article
- Keywords:
Uterine prolapse;
Laparoscopic total hysterectomy;
Quadratus lumborum block;
Opioid drugs;
Pain;
Sleep quality
- From:
Chinese Journal of Endocrine Surgery
2025;19(2):281-285
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application effect of quadratus lumborum block (QLB) combined with less opioid anesthesia analgesia in laparoscopic total hysterectomy (LTH) in elderly patients with uterine prolapse.Methods:A total of 86 elderly patients with uterine prolapse who received LTH in the Langfang People’s Hospital from Jan. 2021 to Oct. 2023 were prospectively selected and divided into group A ( n=42) and group B ( n=44) according to the random number table method. Group A received transversus abdominis block (TAPB) + general anesthesia, and group B received QLB combined with less opioid anesthesia + general anesthesia. The pain duration at different time points after operation [Numeric Rating Scale (NRS) method to evaluate resting incision and visceral pain] was compared between the two groups. The dosage of opioids and the additional analgesia rate were compared between the two groups. The sleep quality of the two groups before and 72 hours after operation was compared, and the adverse reactions of anesthesia were counted. Results:Compared with 6 h after operation, NRS scores of resting incision pain and visceral pain in the two groups decreased gradually at 12, 24 and 48 h after operation, and it was lower in group B than in group A. There were statistically significant differences between groups ( P<0.05) . Dosage of sufentanil and remifentanil in group B was lower than that in group A, and the postoperative additional analgesia rate in group B (9.09%) was lower than that in group A (28.57%) ( P<0.05) . 72 hours after surgery, the sleep efficiency and total sleep time of patients in both groups were lower than those before surgery, and they were higher in group B than in group A; The awakening time and number of awakenings in both groups were higher than those before surgery, while they were lower in group B than in group A ( P<0.05) . The total incidence of adverse reactions in group B was 4.76% (2/44) , lower than 23.81% (10/42) of group A ( P<0.05) . Conclusion:QLB combined with less opioid anesthesia analgesia can effectively reduce the degree of incision and visceral pain after LTH in elderly patients with uterine prolapse, reduce the amount of opioids used during operation and the rate of additional analgesia, and reduce the incidence of adverse reactions of anesthesia.
