弓状韧带上腰方肌阻滞对腹腔镜胆囊切除患者术后恢复质量的影响

doi:10.20047/j.issn1673-7210.2023.10.20

Abstract
Figure/Table
References (25)
Related Citation (15)

Download: PDF (626 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To observe the effect of supra arcuate-quadratus lumborum block (SA-QLB) on postoperative recovery quality of patients with laparoscopic cholecystectomy. Methods A total of 60 patients undergoing laparoscopic cholecystectomy under elective general anesthesia admitted to Dongfang Hospital Affiliated to Xiamen University from January to April 2022 were selected, they were divided into control group (group C) and SA-QLB group, with 30 cases in each group. SA-QLB group underwent bilateral SA-QLB under ultrasound guidance before anesthesia induction, and group C did not have nerve block. Both groups were treated with combined intravenous-inhalational anesthesia, and patient-controlled analgesia was used after operation. The intraoperative dosage of Propofol and Remifentanil, anesthesia time, and operation time were compared between two groups; visual analogue scale (VAS) scores at rest and cough in upper abdomen and shoulder were compared between two groups at 2, 6, 12, 24 h, and 48 h after operation; the number of effective analgesic pump compressions, the rate of relief analgesia, the incidence of nausea and vomiting, the incidence of urinary retention, the first time to get out of bed, the first time to exhaust gas were compared between two groups within 48 h after operation; and the scores of the 40-item quality of recovery scale (QoR-40) before and after operation were compared between two groups. Results At 2, 6, 12, 24 h, and 48 h after operation, VAS scores of rest and cough in upper abdomen and shoulder in SA-QLB group were lower than those in group C (P＜0.05). The dosages of Propofol and Remifentanil in SA-QLB group were lower than those in group C; the number of effective analgesic pump compressions, the rate of relief analgesia, the incidence of nausea and vomiting were lower than those of group C, and the first time to get out of bed, the first time to exhaust gas were shorter than those of group C (P＜0.05). There was no significant difference in the incidence of urinary retention between two groups (P＞0.05). The grading scores and total scores of QoR-40 in SA-QLB group were higher than those in group C at 24 and 48 h after operation (P＜0.05). Conclusion SA-QLB can improve the postoperative recovery quality of patients undergoing laparoscopic cholecystectomy.

Key words： Psoas muscles Nerve block Arcuate-ligament Cholecystectomy Laparoscopy Quality of recovery

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	WANG Liping* XU Ting* QIU Sheng

Cite this article:

WANG Liping* XU Ting* QIU Sheng. Effect of supra arcuate-quadrat lumborum block on postoperative recovery quality in patients with laparoscopic cholecystectomy[J]. 中国医药导报, 2023, 20(10): 92-95,116.

URL:

https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.10.20 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I10/92

[1] Zhang N，Wu G，Zhou Y，et al. Use of enhanced recovery after surgery（ERAS）in laparoscopic cholecystectomy（LC）combined with laparoscopic common bile duct exploration（LCBDE）：a cohort study [J]. Med Sci Monit，2020，26：e924946.
[2] Kihlstedt Pasquier E，Andersson E. Pulmonary recruitment maneuver reduces shoulder pain and nausea after laparoscopic cholecystectomy：a randomized controlled trial [J]. World J Surg，2021，45（12）：3575-3583.
[3] Toleska M，Dimitrovski A. Is opioid-free general anesthesia more superior for postoperative pain versus opioid general anesthesia in laparoscopic cholecystectomy? [J]. Pril（Makedon Akad Nauk Umet Odd Med Nauki），2019，40（2）：81-87.
[4] Feinberg AE，Acuna SA，Smith D，et al. Optimizing opioid prescriptions after laparoscopic appendectomy and cholecystectomy [J]. Can J Surg，2021，64（1）：E69-E75.
[5] Simpson JC，Bao X，Agarwala A. Pain management in enhanced recovery after surgery（ERAS）protocols [J]. Clin Colon Rectal Surg，2019，32（2）：121-128.
[6] Li H，Liang J，Shao P，et al. Supra-arcuate ligament blocks：anatomy，mechanisms，and techniques [J]. J Pain Res，2021， 14：3837-3848.
[7] 邵沛琪，王云.弓状韧带上腰方肌阻滞的解剖基础和临床应用[J].中华麻醉学杂志，2022，42（1）：117-120.
[8] 王丽萍，邱晟，高金梅，等.腹腔镜妇科手术麻醉的优化：弓状韧带上腰方肌前侧阻滞联合全身麻醉[J].中华麻醉学杂志，2022，42（5）：581-585.
[9] Myles PS，Weitkamp B，Jones K，et al. Validity and reliability of a postoperative quality of recovery score：the QoR-40 [J]. Br J Anaesth，2000，84（1）：11-15.
[10] Liang M，Chen Y，Zhu W，et al. Efficacy and safety of different doses of ropivacaine for laparoscopy-assisted infiltration analgesia in patients undergoing laparoscopic cholecystectomy：a prospective randomized control trial [J]. Medicine（Baltimore），2020，99（46）：e22540.
[11] Grape S，Kirkham KR，Akiki L，et al. Transversus abdominis plane block versus local anesthetic wound infiltration for optimal analgesia after laparoscopic cholecystectomy：a systematic review and meta-analysis with trial sequential analysis [J]. J Clin Anesth，2021，75：110450.
[12] Shi R，Li H，Wang Y. Dermatomal coverage of single-injection ultrasound-guided parasagittal approach to anterior quadratus lumborum block at the lateral supra-arcuate ligament [J]. J Anesth，2021，35（2）：307-310.
[13] 阳婷婷，宋珂珂，汪博，等.超声引导下双侧弓状韧带上腰方肌阻滞在宫颈癌根治术患者术后镇痛的效果[J].临床麻醉学杂志，2022，38（3）：265-269.
[14] 蔡敏，尹泓，易明亮，等.超声引导下经弓状韧带上或前路腰方肌阻滞在腹腔镜全子宫切除术中的比较[J].临床麻醉学杂志，2022，38（3）：229-233.
[15] Yang SC，Chang KY，Wei LF，et al. To drain or not to drain：the association between residual intraperitoneal gas and post-laparoscopic shoulder pain for laparoscopic cholecystectomy [J]. Sci Rep，2021，11（1）：7447.
[16] Das NT，Deshpande C. Effects of intraperitoneal local anaesthetics bupivacaine and ropivacaine versus placebo on postoperative pain after laparoscopic cholecystectomy：a randomized double blind study [J]. J Clin Diagn Res，2017， 11（7）：UC08-UC12.
[17] Bao X，Huang J，Feng H，et al. Effect of local anesthetic volume（20 ml vs 30 ml ropivacaine）on electromyography of the diaphragm and pulmonary function after ultrasound-guided supraclavicular brachial plexus block：a randomized controlled trial [J]. Reg Anesth Pain Med，2019，44（1）：69-75.
[18] Emile SH，Elfeki H，Elbahrawy K，et al. Ultrasound-guided versus laparoscopic-guided subcostal transversus abdominis plane（TAP）block versus NO TAP block in laparoscopic cholecystectomy：a randomized double-blind controlled trial [J]. Int J Surg，2022，101：106639.
[19] Elsharkawy H，EI-Boghdadly K，Barrington M. Quadratus lumborum block：anatomical concepts，mechanisms，and techniques [J]. Anesthesiology，2019，130（2）：322-335.
[20] Li H，Ma D，Liu Y，et al. A transverse approach for ultrasound-guided anterior quadratus lumborum block at the lateral supra-arcuate ligament [J]. Anaesthesia，2020，75（10）：1400-1401.
[21] Li H，Shi R，Wang Y. A modified approach below the lateral arcuate ligament to facilitate the subcostal anterior quadratus lumborum block [J]. J Pain Res，2021，14：961- 967.
[22] Chen Y，Wang J，Liu S，et al. Development and validation of the Chinese version of the quality of recovery-40 questionnaire [J]. Ther Clin Risk Manag，2020，16：1165-1173.
[23] Myles PS，Hunt JO，Fletcher H，et al. Relation between quality of recovery in hospital and quality of life at 3 months after cardiac surgery [J]. Anesthesiology，2001，95（4）：862- 867.
[24] Murphy GS，Szokol JW，Greenberg SB，et al. Preoperative dexamethasone enhances quality of recovery after laparoscopic cholecystectomy：effect on in-hospital and postdischarge recovery outcomes [J]. Anesthesiology，2011，114（4）：882-890.
[25] Myles PS，Myles DB，Galagher W，et al. Minimal clinically important difference for three quality of recovery scales [J]. Anesthesiology，2016，125（1）：39-45.