Evaluation of the analgesic efficacy of ultrasound-guided quadratus lumborum block for laparoscopic renal surgery: a randomized controlled trial

超声引导下腰方肌阻滞镇痛在腹腔镜肾脏手术中的疗效评价:一项随机对照试验

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Abstract

PURPOSE: To evaluate the analgesic efficacy of ultrasound-guided quadratus lumborum block (QLB) for laparoscopic renal surgery. METHODS: Sixty-eight patients who underwent unilateral laparoscopic renal surgery were enrolled. All patients were separated into two groups: group QLB (n = 34) and group C (n = 34). Patients in the QLB group underwent unilateral anterior QLB before the induction of anesthesia. Patients in group C underwent laparoscopic renal surgery with no block. Postoperative NRS scores at rest and during movement at 6, 12, 24, 48 h were assessed. Remedial analgesia and the incidence of adverse reactions within 48 h after surgery were recorded. The quality of recovery was compared at 24 and 48 h after the operation via the postoperative quality recovery scale. RESULTS: At 6, 12, 24 h postoperatively, the QLB group had lower resting and moving NRS scores than did the C group (P < 0.05). The QLB group had lower numbers of PCAs, remedial analgesia and incidences of nausea and vomiting within 48 h (P < 0.05). The time to first walk and exhaust was shorter in the QLB group (P < 0.05). The recovery rates of nociceptive and emotional factors at 24, 48 h in the QLB group were greater (P < 0.05). The recovery rates of the activities of daily living (ADL) factors at 24 h in the QLB group were greater (P < 0.05). CONCLUSIONS: QLBs are more effective at alleviating pain in patients undergoing laparoscopic renal surgery, which is beneficial for reducing the use of opioids, alleviating adverse reactions, improving the quality of recovery.

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