Effect of ultrasound-guided anterior quadratus lumborum block at supra-arcuate ligament on quality of postoperative recovery in patients undergoing laparoscopic surgery
10.3760/cma.j.cn131073-20241011-00312
- VernacularTitle:超声引导下弓状韧带上腰方肌前侧阻滞对腹腔镜手术患者术后恢复质量的影响
- Author:
Xueyan GUO
1
;
Di WANG
1
;
Hong HONG
1
;
Muhuog JI
1
;
Jianhua TONG
1
Author Information
1. 南京医科大学第二附属医院麻醉科，南京 210011
- Publication Type:Journal Article
- Keywords:
Ultrasonography;
Psoas muscle;
Nerve block;
Arcuate ligament;
Laparoscopy;
Recovery quality
- From:
Chinese Journal of Anesthesiology
2025;45(3):325-328
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of ultrasound-guided anterior quadratus lumborum block at the supra-arcuate ligament (SA-AQLB) on the quality of postoperative recovery in patients undergoing laparoscopic surgery.Methods:In this randomized controlled study, 110 American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients, aged 18-80 yr, with a body mass index of 18-28 kg/m 2, scheduled for elective laparoscopic surgery, were assigned to 2 groups( n=55 each) using a random number table method: transversus abdominis plane block (TAPB) group (group T) and SA-AQLB group (group S). The patients were sent to postanesthesia care unit and connected to patient-controlled intravenous analgesia (PCIA) pump after surgery. T group received ultrasound-guided bilateral TAPB and S group received ultrasound-guided bilateral SA-AQLB at 5 min after removal of the endotracheal tube under ultrasound guidance, with 30 ml of 0.25% ropivacaine injected on each side. Oxycodone 3-5 mg or diazoxide 5 mg was intravenously injected when the numerical rating scale score ≥4, and the requirement for rescue analgesia was recorded. The time to the first pressing and effective pressing times of PCIA were recorded, and the equivalent consumption of sufentanil at 24 h after operation was also recorded.The Quality of Recovery-15 scores were recorded at 24 and 48 h after surgery. The time to first ambulation and postoperative length of hospital stay were recorded. The occurrence of postoperative dizziness, nausea and vomiting, respiratory depression and nerve block complications was recorded. Results:Compared with group T, the equivalent consumption of sufentanil at 24 h postoperatively was significantly decreased, the effective pressing times of PCIA were reduced, the rate of rescue analgesia was decreased, the time to the first pressing of PCIA was prolonged, Quality of Recovery-15 scores were increased at 24 and 48 h after surgery, and the time to first ambulation and postoperative length of hospital stay were shortened in group S( P<0.05). Conclusions:Ultrasound-guided SA-AQLB is more effective than TAPB in improving the quality of postoperative recovery in patients undergoing laparoscopic surgery.
