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| Effect of ultrasound-guided quadratus lumbois block on early outcome after renal transplantation |
| ZHOU Ruhong YANG Xuliang HE Aimei LI Hong |
| Department of Anesthesiology, the 924th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China, Guangxi Zhuang Autonomous Region, Guilin 541002, China |
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Abstract Objective To investigate the effect of ultrasound-guided quadratus lumbois block on early outcome of renal transplantation. Methods Sixty patients with end-stage renal disease who underwent kidney transplantation at the 924th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China from January 2021 to January 2023 were selected, according to the random number table method, they were divided into quadratus lumbois block group (group Q) and transversal muscle plane block group (group T), with 30 patients in each group. After successful induction of anesthesia, group Q was subjected to ultrasound-guided quadratus lumbois, group T was subjected to ultrasound-guided transversal muscle plane block. Heart rate (HR) and mean arterial pressure (MAP) were compared immediately before skin incision and five minutes after skin incision; the intraoperative doses of Sufentanil and Remifentanil were compared between two groups; the postoperative recovery indexes of two groups were compared; visual analog scale (VAS) score was compared between two groups extubation for 15 min, 2 h after surgery, 12 h after surgery, 24 h after surgery, and 48 h after surgery; complications during postoperative analgesia, effective compression times, and remedial analgesia were compared between two groups; the changes of stress inflammatory response before anesthesia and 48 h after surgery were compared between two groups. Results There were no statistically significant difference in HR and MAP intra-group and inter-group comparison between two groups immediately before skin incision and five minutes after skin incision (P＞0.05). The intraoperative doses of Sufentanil and Remifentanil of group Q were lower than those of group T, and the differences were statistically significant (P＜0.05). The postoperative resuscitation and extubation time, first time out of bed, and hospitalization time of group Q were shorter than those of group T, and the differences were statistically significant (P＜0.05). The overall analysis showed that there were statistically significant differences in the inter-group, time, and interaction of VAS between two groups (P＜0.05). Intra-group comparison: VAS scores at 2, 12, 24 h, and 48 h after surgery in both groups were higher than those at extubation of 15 min; VAS scores at 12, 24 h, and 48 h after surgery in both groups were higher than those at 2 h after surgery; VAS scores at 24 h and 48 h after surgery in both groups were higher than those at 12 h after surgery; VAS scores at 48 h after surgery in both groups were lower than those at 24 h after surgery, and the differences were statistically significant (P＜0.05). Comparison between groups: VAS scores of group Q at 2, 12, 24 h, and 48 h after surgery were lower than those of group T, and the differences were statistically significant (P＜0.05). There were no significant differences in the total incidence of complications and the rate of remedial analgesia between two groups (P＞0.05). The effective compression times of group Q was less than that of group T, and the difference was statistically significant (P＜0.05). The levels of cortisol, C-reactive protein, interleukin-6, and tumor necrosis factor-α at 48 h after surgery in two groups were higher than those before anesthesia, and those of group Q were lower than those of group T, and the differences were statistically significant (P＜0.05). Conclusion Ultrasound-guided quadratus lumbois block can accelerate the early recovery after kidney transplantation, the postoperative analgesia is significant, and the effect of stress and inflammatory response is small.
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