超声引导前路腰方肌阻滞对腹腔镜胆囊切术患者术后镇痛效果的影响

目的 观察超声引导前路腰方肌阻滞对腹腔镜胆囊切除术患者术后镇痛效果的影响。方法 随机选择我院2018 年11 月～2019 年1 月择期行腹腔镜胆囊切除术患者70 例，按随机数字表法分为前路腰方肌阻滞组（Q组）和对照组（C 组），每组35 例。Q 组患者术前行双侧前路腰方肌阻滞，每侧注射0.375%罗哌卡因20 mL，术中行全身麻醉；C 组患者行单纯全身麻醉。术后均连接吗啡静脉自控镇痛泵。记录患者术后1 h、2 h、6 h、12 h 和24 h静息痛和运动痛的VAS 评分，评估患者的镇静状态，记录术后吗啡用量和不良反应发生情况。结果 与C 组相比，Q 组患者术后2 h、6 h、12 h 的静息痛VAS 评分和各个随访时间点的运动痛VAS 评分显著下降（P<0.05）。Q 组患者术后24 h 内吗啡用量显著少于C 组（P＜0.05），且术后恶心呕吐发生率较C 组显著下降（P＜0.05）。结论 超声引导前路腰方肌阻滞可改善腹腔镜胆囊切除术患者术后镇痛效果，减少吗啡用量，术后并发症少。

Effect of ultrasound-guided anterior quadratus lumborum block on postoperative analgesia effect in patients undergoing laparoscopic cholecystectomy

Objective To observe the effect of ultrasound-guided anterior quadratus lumborum block on postoperative analgesia effect in the patients undergoing laparoscopic cholecystectomy.Methods A total of 70 patients undergoing elective laparoscopic cholecystectomy from November 2018 to January 2019 in our hospital were randomly selected.The patients were divided into anterior quadratus lumborum block group(group Q) and control group(group C) according to the random number table method,with 35 patients in each group.Both groups were given bilateral anterior quadratus lumborum puncture before surgery.The group Q was injected with 20 mL of 0.375% ropivacaine on each side.The group C was given general anesthesia alone.All patients were connected with morphine intravenous self-control analgesia pump after surgery.The VAS scores of resting pain and exercise pain at 1 h,2 h,6 h,12 h,and 24 h after surgery were recorded,and the patient''s sedation was evaluated.The postoperative morphine dosage and adverse reactions were recorded.Results Compared with group C,the VAS scores of resting pain at 2h,6h,and 12h after surgery and the VAS scores of exercise pain at each follow-up time point in group Q were significantly decreased(P<0.05).The amount of morphine in group Q in 24h after surgery was significantly lower than that in group C(P<0.05),and the incidence rate of postoperative nausea and vomiting was significantly lower than that in the group C(P<0.05).Conclusion Ultrasound-guided anterior quadratus lumborum block can improve postoperative analgesia effect,reduce morphine dosage and has fewer postoperative complications in the patients undergoing laparoscopic cholecystectomy.