Retrospective Analysis: Comparative Effects of General Anesthesia versus Quadratus Lumborum Block-Supplemented General Anesthesia on Postoperative Outcomes in Patients Undergoing Laparoscopic Myomectomy

回顾性分析:全身麻醉与腰方肌阻滞辅助全身麻醉对腹腔镜子宫肌瘤切除术患者术后结局的比较研究

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Abstract

BACKGROUND AND OBJECTIVE: This retrospective study analyzed to compare the effects of general anesthesia (GA) versus combined anesthesia (CA) on postoperative pain and negative emotions in patients undergoing uterine fibroid surgery, providing evidence for optimizing anesthesia protocols aiming to achieve more effective analgesia and improve patient satisfaction scores. METHODS: A retrospective analysis was conducted on data from 148 patients who underwent uterine fibroid surgery at a tertiary hospital between April 2023 and December 2024. Patients were divided into a control group (GA) and a study group (CA) based on anesthesia type. The control group received conventional GA, while the study group received ropivacaine quadratus lumborum block (QLB) combined with GA. After propensity score matching (PSM), 74 patients were included in each group. The primary outcome was postoperative 2-12h visual analog scale (VAS) pain scores. Secondary outcomes included stress indicators (ACTH, Cor), emotional scales (SAS/SDS), cognitive function (MMSE), and sleep quality (PSQI). RESULTS: The study group had shorter anesthesia duration, postoperative flatus time, postoperative ambulation time, and hospital stay compared to the control group (all P<0.05). VAS scores at 2h, 4h, 8h, and 12h postoperatively were significantly lower in the study group (all P<0.05). Preoperative differences in emotional, stress, cognitive, and sleep indicators were not statistically significant (all P>0.05). Postoperatively, the study group showed significantly lower SAS/SDS scores, ACTH/Cor levels, and PSQI scores, alongside higher MMSE scores compared to the control group (all P<0.05). CONCLUSION: Combined anesthesia effectively reduces postoperative pain and negative emotions in uterine fibroid patients, lowers stress levels, improves sleep quality, and promotes rapid recovery, making it worthy of clinical promotion.

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