腰方肌阻滞在剖宫产术后镇痛中的临床应用

剖宫产是妇产科最常见的手术之一。围术期疼痛和镇痛药物对哺乳的影响是产妇焦虑的问题之一。目前，多模式镇痛策略已广泛用于剖宫产术后镇痛，其中腰方肌阻滞（QLB）是术后多模式镇痛的主要措施之一。QLB是将局麻药注射到腰方肌（QL）肌肉内或QL周围筋膜间隙的一种阻滞技术，是后腹壁肌肉之间的浅筋膜阻滞，可获得T10—T12阻滞范围，对剖宫产的切口痛和内脏痛均有良好的镇痛效果。QLB相对安全，但仍应警惕交感神经及脊神经阻滞、药物毒性、穿刺置管相关并发症。本文将围绕QLB在剖宫产术后镇痛中的临床应用进行综述。

Clinical application of quadratus lumbarus muscle block in postoperative analgesia after cesarean section

Caesarean section is one of the most common operations in obstetrics and gynecology. The effect of perioperative pain and an analgesics on breastfeeding is big concern in pregnant women. At present, multi-mode analgesia strategies have been widely used in post-caesarean section analgesia, among which quadratus lumborum block (QLB) is one of the main measures for postoperative multi-mode analgesia. QLB is a blocking technology that a local anesthetic is injected into the muscle of the quadratus lumborum (QL) or into the fascia space around the QL. It is a shallow fascia between the posterior abdominal muscles. The T10-T12 block range can be obtained, which has a good analgesic effect on the incision pain of caesarean section and visceral pain in the internal organs. Although QLB is relatively safe, we should still be vigilant against complications related to sympathetic and spinal nerve block, drug toxicity and puncture. This article will review the clinical application of QLB in analgesic after caesarean section.