地塞米松用于LQLB对妇科腹腔镜患者术后QoR的影响  

Effect of dexamethasone on quadratus lumborum block for the postoperative quality of recovery after gynecological laparoscopic surgery

作　　者：张富荣[1] 王玥 李世阔 汪杰 杨也天 尹建伟[1] ZHANG Furong;WANG Yue;LI Shikuo;Wang Jie;YANG Yetian;YIN Jianwei(Department of Anesthesiology,Yan an Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650000,China;Department of Anesthesiology,People s Hospital of Chuxiong Yi Autonomous Prefecture,Chuxiong Yunnan 675000,China)

机构地区：[1]昆明医科大学附属延安医院麻醉科,云南昆明650051 [2]楚雄彝族自治州人民医院麻醉科,云南楚雄675000

出　　处：《云南医药》2024年第5期23-26,共4页Medicine and Pharmacy of Yunnan

基　　金：昆明市卫生科技人才培养项目[2022-SW(技)-30];昆明市卫生健康委员会卫生科研项目(2022-04-11-03)。

摘　　要：目的探讨地塞米松作为佐剂行LQLB对妇科腹腔镜患者术后QoR的影响。方法选取2022年10月-2023年1月本院择期行妇科腹腔镜良性肿瘤手术患者70例,随机分为LD组(地塞米松复合罗哌卡因,n=35)和L组(罗哌卡因,n=35)行LQLB,对比2组术后QoR、VAS评分、镇痛补救情况、PONV发生率及严重程度、镇吐补救次数、术后首次肛门排气时间。结果与L组相比,LD组患者术后1d QoR-40评分更高、术后24h及48h VAS评分更低、镇痛补救次数减少、首次镇痛药物使用时间更长、术后48h内PONV发生率和严重程度更低、术后首次肛门排气时间更短,差异有统计学意义(P<0.05)。结论地塞米松作为佐剂行LQLB镇痛效果更完善、PONV发生率及严重程度降低、胃肠功能恢复快,有效提高妇科腹腔镜手术患者的术后QoR。Objective To investigate the effect of dexamethasone as an adjuvant on lateral quadratus lumborum block(LQLB)for the postoperative quality of recovery of patients undergoing gynecological laparoscopic surgery.Methods A total of 70 women underwent gynecological laparoscopic surgery for benign tumors from October 2022 to January 2023 were selected,and randomly divided them into group LD(dexamethasone combined with ropivacaine,n=35)and group L(ropivacaine,n=35)with LQLB.The postoperative quality of recovery(QoR)score,visual analogue score(VAS),analgesic drugs remedial,the incidence and severity of postoperative nausea and vomiting(PONV)and the number of antiemetic drugs remedies,the time of first anal exhaust after surgery were recorded.Results Compared with group L,the total score of QoR-40 after surgery was significantly higher,the VAS at 24 and 48h after surgery were lower and the time of first postoperative remedial analgesic was longer,the incidence and severity of PONV within 48 hours after surgery were lower and the time of first anal exhaust after surgery was shorter in LD group,the difference was statistically significant(P<0.05).Conclusions Dexamethasone as an adjuvant in LQLB has more perfect analgesic effect,lower incidence and severity of PONV,faster recovery of gastrointestinal function,and effectively improve the postoperative QoR in gynecological laparoscopic surgery.

关 键 词：腰方肌阻滞 地塞米松 恢复质量 腹腔镜手术 

分 类 号：R614[医药卫生—麻醉学]