超声引导前路腰方肌阻滞对腹腔镜胆囊切除术患者术后镇痛效果的影响  

Effect of ultrasound-guided anterior quadratus lumborum block on postoperative analgesia effect in patients undergoing laparoscopic cholecystectomy

作　　者：黄绿丹 夏芳芳[1] 倪旭青[1] 张竞雄[1] 陈鸿飞[1] HUANG Lvdan;XIA Fangfang;NI Xuqing;ZHANG Jingxiong;CHEN Hongfei(Department of Anesthesiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou325000,China)

机构地区：[1]温州医科大学附属第一医院麻醉科,浙江温州325000

出　　处：《中国现代医生》2020年第7期118-121,共4页China Modern Doctor

基　　金：浙江省基础公益研究计划(Q18H090027);浙江省温州市科技局科研基金资助项目(Y20180589)。

摘　　要：目的观察超声引导前路腰方肌阻滞对腹腔镜胆囊切除术患者术后镇痛效果的影响。方法随机选择我院2018年11月~2019年1月择期行腹腔镜胆囊切除术患者70例,按随机数字表法分为前路腰方肌阻滞组(Q组)和对照组(C组),每组35例。Q组患者术前行双侧前路腰方肌阻滞,每侧注射0.375%罗哌卡因20 mL,术中行全身麻醉;C组患者行单纯全身麻醉。术后均连接吗啡静脉自控镇痛泵。记录患者术后1 h、2 h、6 h、12 h和24 h静息痛和运动痛的VAS评分,评估患者的镇静状态,记录术后吗啡用量和不良反应发生情况。结果与C组相比,Q组患者术后2 h、6 h、12 h的静息痛VAS评分和各个随访时间点的运动痛VAS评分显著下降(P<0.05)。Q组患者术后24 h内吗啡用量显著少于C组(P<0.05),且术后恶心呕吐发生率较C组显著下降(P<0.05)。结论超声引导前路腰方肌阻滞可改善腹腔镜胆囊切除术患者术后镇痛效果,减少吗啡用量,术后并发症少。Objective To observe the effect of ultrasound-guided anterior quadratus lumborum block on postoperative analgesia effect in the patients undergoing laparoscopic cholecystectomy.Methods A total of 70 patients undergoing elective laparoscopic cholecystectomy from November 2018 to January 2019 in our hospital were randomly selected.The patients were divided into anterior quadratus lumborum block group(group Q)and control group(group C)according to the random number table method,with 35 patients in each group.Both groups were given bilateral anterior quadratus lumborum puncture before surgery.The group Q was injected with 20 mL of 0.375%ropivacaine on each side.The group C was given general anesthesia alone.All patients were connected with morphine intravenous self-control analgesia pump after surgery.The VAS scores of resting pain and exercise pain at 1 h,2 h,6 h,12 h,and 24 h after surgery were recorded,and the patient's sedation was evaluated.The postoperative morphine dosage and adverse reactions were recorded.Results Compared with group C,the VAS scores of resting pain at 2h,6h,and 12h after surgery and the VAS scores of exercise pain at each follow-up time point in group Q were significantly decreased(P<0.05).The amount of morphine in group Q in 24h after surgery was significantly lower than that in group C(P<0.05),and the incidence rate of postoperative nausea and vomiting was significantly lower than that in the group C(P<0.05).Conclusion Ultrasound-guided anterior quadratus lumborum block can improve postoperative analgesia effect,reduce morphine dosage and has fewer postoperative complications in the patients undergoing laparoscopic cholecystectomy.

关 键 词：超声引导 前路腰方肌阻滞 腹腔镜胆囊切除术 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]