摘要
目的评价全身麻醉复合腰方肌阻滞(quadratus lumborum block,QLB)对肾移植手术的临床效果。方法按随机数字表法将50例患者分为QLB组和对照组(每组25例):QLB组术前在超声引导下于术侧行QLB,给予0.375%罗哌卡因25 ml后行全身麻醉;对照组行单纯全身麻醉。主要观察指标为术后0、2、6、12、24、48 h静息及运动VAS疼痛评分,术后48 h内各时间段舒芬太尼用量,次要观察指标为术中瑞芬太尼及丙泊酚用量、术后48 h内患者自控静脉镇痛(patient‑controlled intra‑venous analgesia,PCIA)镇痛泵按压次数和不良反应发生情况。结果QLB组患者术后0、2、6、12、24 h静息和运动VAS疼痛评分低于对照组。术后2~6 h、6~12 h、12~24 h、24~48 h舒芬太尼用量,术中瑞芬太尼和丙泊酚用量,术后0~24 h内PCIA镇痛泵按压次数,术后恶心发生率等,QLB组均低于对照组(P<0.05)。其余指标两组间差异无统计学意义(P>0.05)。结论相比于仅在术后应用PCIA,QLB可显著缓解肾移植患者的术后疼痛,也可减少术中及术后镇静镇痛药物的用量。
Objective To evaluate the clinical effectiveness of general anesthesia combined with quadratus psoas block(QLB)on renal transplantation.Methods According to the random number table method,50 patients were divided into two groups(n=25):a QLB group and a control group.In the QLB group,QLB was performed under ultrasound guidance on the operating side be‑fore surgery,while 25 ml of 0.375%ropivacaine was given before general anesthesia.The control group received general anesthesia alone.The primary outcomes were the Visual Analogue Scale(VAS)scores at resting and during movement 0,2,6,12,24 h and 48 h af‑ter surgery,as well as the dose of sufentanil in each time period within 48 h after surgery.The secondary outcomes were the intraopera‑tive dosage of remifentanil and propofol,the number of compression on the analgesic pump of patient‑controlled intravenous analgesia(PCIA)within 48 h after surgery,and adverse reactions.Results The QLB group showed lower VAS scores at resting and during movement 0,2,6,12 h and 24 h after surgery than the control group.Compared with the control group,the QLB group presented de‑creases in the dose of sufentanil 2‒6 h,6‒12 h,12‒24 h,and 24‒48 h after surgery,the intraoperative dosage of remifentanil and pro‑pofol,and the times of compression on PCIA analgesia pump 0‒24 h after surgery,and the incidence of postoperative nausea(P<0.05).There were no statistical difference as to other indicators between the two groups(P>0.05).Conclusions Compared with the use of PCIA after surgery alone,QLB can significantly relieve postoperative pain in renal transplantation patients and reduce the dosages of sedative and analgesic agents during and after surgery.
作者
蒋梦迪
王飞
高成杰
Jiang Mengdi;Wang Fei;Gao Chengjie(Department of Anesthesiology,Zibo Central Hospital,Zibo 255000,China;Department of Anesthesiology,the 960th Hospital of the PLA,Jinan 250031,China)
出处
《国际麻醉学与复苏杂志》
CAS
2021年第6期584-588,共5页
International Journal of Anesthesiology and Resuscitation
关键词
腰方肌阻滞
肾移植
镇痛
超声引导
Quadratus lumborum block
Renal transplantation
Analgesia
Ultrasound‑guided
