超声引导下后路腰方肌阻滞对腹腔镜全子宫切除术后镇痛效果的影响  

Effect of ultrasound-guided posterior quadratus lumborum block on postoperative analgesia after laparoscopic total hysterectomy

作　　者：朱莉敏[1] 杨咏[1] 朱恩华[1] 洪李萍[1] ZHU Limin;YANG Yong;ZHU Enhua;HONG Liping(Jiangdu People's Hospital of Yangzhou,Yangzhou 225200,China)

机构地区：[1]扬州市江都人民医院,江苏扬州225200

出　　处：《临床医学研究与实践》2023年第29期69-72,共4页Clinical Research and Practice

摘　　要：目的探讨超声引导下后路腰方肌阻滞对腹腔镜全子宫切除术后镇痛效果的影响。方法选取2020年1月至2021年12月在扬州市江都人民医院择期进行腹腔镜全子宫切除术的66例患者为研究对象,按照随机数字表法将其分为对照组和观察组,每组33例。对照组直接给予全身麻醉,观察组在麻醉诱导前30 min行超声引导下后路腰方肌阻滞。比较两组的疼痛程度、血流动力学指标、恢复质量及不良反应发生情况。结果术后2 h(T_(1))~术后48 h(T_(5)),观察组静息状态下的视觉模拟评分法(VAS)评分均明显低于对照组,差异具有统计学意义(P<0.05)。T_(1)~术后24 h(T_(4)),两组的平均动脉压(MAP)、心率(HR)比较,差异无统计学意义(P>0.05)。术后12 h(T_(3))、T_(4),观察组的15项恢复质量评分量表(QoR-15)评分高于对照组,差异具有统计学意义(P<0.05)。观察组的恶心呕吐发生率明显低于对照组,差异具有统计学意义(P<0.05);两组的头晕头痛、皮肤瘙痒的发生率比较,差异无统计学意义(P>0.05)。结论超声引导下后路腰方肌阻滞用于腹腔镜全子宫切除术后的镇痛效果佳,能减少患者住院期间不良反应发生情况,提升术后恢复质量,值得应用及推广。Objective To explore the effect of ultrasound-guided posterior quadratus lumborum block on postoperative analgesia after laparoscopic total hysterectomy.Methods A total of 66 patients who underwent elective laparoscopic total hysterectomy in Jiangdu People's Hospital of Yangzhou from January 2020 to December 2021 were selected as the research objects.According to the random number table method,the patients were divided into control group and observation group,with 33 cases in each group.The control group was directly given general anesthesia,and the observation group underwent ultrasound-guided posterior quadratus lumborum block at 30 min before anesthesia induction.The pain degree,hemodynamic indexes,recovery quality and the incidence of adverse reactions were compared between the two groups.Results From 2 h after operation(T_(1))to 48 h after operation(T_(5)),the Visual Analogue Scale(VAS)score of the observation group at rest was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).From T_(1) to 24 h after operation(T_(4)),there was no significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups(P>0.05).At 12 h after operation(T_(3))and T_(4),the Quality of Recovery-15(QoR-15)score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The incidence of nausea and vomiting in the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05);there were no significant differences in the incidences of dizziness,headache and skin itching between the two groups(P>0.05).Conclusion Ultrasound-guided posterior quadratus lumborum block has a good analgesic effect after laparoscopic total hysterectomy,which can reduce the incidence of adverse reactions during hospitalization and improve the postoperative recovery quality,it is worthy of application and promotion.

关 键 词：超声引导 后路腰方肌阻滞 腹腔镜全子宫切除术 

分 类 号：R71[医药卫生—妇产科学]