摘要
目的探讨经切口腰方肌阻滞(transincisional quadratus lumborum block,TQLB)技术在肾切除术中的镇痛作用及安全性。方法选取2023年12月至2024年3月在宁波大学附属李惠利医院择期行后腹腔镜下肾切除术患者60例,采用随机数字表法分为TQLB组(T组)与对照组(C组),每组30例。C组采用气管插管全身麻醉,T组采用TQLB复合气管插管全身麻醉。两组患者术后常规给予舒芬太尼自控静脉镇痛泵。记录两组患者的切口愈合情况,术后24h舒芬太尼消耗量;术后6h、12h、24h的静息和运动时数字分级评分法(numerical rating scale,NRS)评分,术后2h感觉阻滞范围,术后24h补救镇痛例数、镇痛满意度评分及术后并发症的发生情况。结果与C组比较,T组患者术后24h舒芬太尼消耗量减少(P<0.001);术后6h、12h、24h静息和运动NRS评分降低(P<0.05);术后24h补救镇痛例数及镇痛满意度评分均低于C组(P<0.05);T组术后恶心、呕吐发生率较低(P<0.05)。两组患者均未发生严重并发症。结论TQLB可为后腹腔镜肾切除术患者术后早期提供良好的镇痛效果,且发症少,为该类手术提供一种安全有效的新型镇痛方法。
Objective To investigate the analgesic effect and safety of transincisional quadratus lumborum block(TQLB)technique for laparoscopic nephrectomy.Methods Sixty patients scheduled for laparoscopic nephrectomy at the Affiliated Lihuili Hospital of Ningbo University from December 2023 to March 2024,the patients were randomly divided into TQLB group(T group)and control group(C group)using a random number table method,with 30 cases in each group.C group received general anesthesia with tracheal intubation,while T group received general anesthesia with tracheal intubation combined with TQLB.Two groups of patients were routinely given sufentanil controlled intravenous analgesia pump after surgery.Record the wound healing status of two groups of patients,postoperative 24h sufentanil consumption,resting and exercise time numerical rating scale(NRS)scores at 6h,12h,and 24h postoperatively,range of sensory blockade at 2h postoperatively,number of salvage analgesia cases at 24h postoperatively,analgesic satisfaction score,and incidence of postoperative complications.Results Compared with group C,patients in group T had a reduced consumption of sufentanil 24h after surgery(P<0.001);The resting and exercise NRS scores decreased at 6h,12h,and 24h after surgery(P<0.05);The number of postoperative 24h rescue analgesia cases and the satisfaction score of analgesia were both lower than C group(P<0.05);The incidence of postoperative nausea and vomiting in group T was lower(P<0.05);Both groups of patients did not experience serious complications.Conclusion TQLB appears to offer effective postoperative analgesia during the early stages of laparoscopic nephrectomy,while also reducing the occurrence of complications.This suggests that it could serve as a safe and efficient alternative for analgesic management in such surgical procedures.
作者
王玲志
周瑞芬
应骐潞
陈力
朱曼华
WANG Lingzhi;ZHOU Ruifen;YING Qilu;CHEN Li;ZHU Manhua(Department of Anesthesiology,the Affiliated Lihuili Hospital of Ningbo University,Ningbo Medical Center Lihuili Hospital,Ningbo 315040,Zhejiang,China;Department of Urology,the Affiliated Lihuili Hospital of Ningbo University,Ningbo Medical Center Lihuili Hospital,Ningbo 315040,Zhejiang,China)
出处
《中国现代医生》
2024年第24期1-5,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2020KY866)。
关键词
经切口腰方肌阻滞
后腹腔镜
肾切除术
镇痛
Transincisional quadratus lumborum block
Retroperitoneoscope
Nephrectomy
Analgesia
作者简介
通信作者:朱曼华,电子信箱:jszhumanhua@163.com。
