Journal of Hebei Medical University ›› 2020, Vol. 41 ›› Issue (12): 1450-1454.doi: 10.3969/j.issn.1007-3205.2020.12.019

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Comparison of the analgesic effect of quadratus lumborum block and transversus abdominis plane block in gynecological laparoscopic surgery

  

  1. 1.Department of Anesthesiology, Jieyang people's Hospital, Guangdong Province, Jieyang 522000, China; 
    2.Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, 
    Guangdong Province, Zhanjiang 524000, China; 3.Graduate School of Youjiang 
    Medical College for Nationalities, Guangxi Province, Baise 533000, China
  • Online:2020-12-25 Published:2021-01-04

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Abstract: Objective To analyze the analgesic effect of quadratus lumborum block and transversus abdominis plane block in gynecological laparoscopic surgery. 
Methods Fifty patients undergoing laparoscopic ovarian tumor resection were selected and divided into two groups. They were quadratus lumborum block(QLB) group and transverse abdominis plane block(TAP) group, 25 cases in each group. Tracheal intubation and total intravenous anesthesia were used in both groups.Before anesthesia induction, QLB group received bilateral quadratus lumborum block, TAP group received bilateral transversus abdominis plane block. Patient controlled intravenous analgesia was used postoperatively in both groups. The following indexes were compared between the two groups, including visual analogue scale(VAS) score of resting pain at 2, 6, 12, 24, 48 hours after operation, the time of first pressing analgesia pump, the effective pressing times of analgesia pump within 48 hours, the total amount of sufentanil used and the number of cases of remedial analgesia with flurbiprofen axetil, the incidence of adverse reactions at 48 hours after operation. 
Results The VAS score of resting pain at each time point in the two groups showed a gradual increase and then a downward trend. The most severe pain occurred 24 hours after operation, and the QLB group was lower than the TAP group. The differences between intergroup, time point and interaction of intergroup and time point of two groups had the statistically significant(P＜0.05). Compared with the TAP group, the first pressing time of analgesia pump in the QLB group was significantly longer(P＜0.05), the effective pressing times of analgesia pump within 48 hours, the total use of sufentanil and the number of cases of rescue analgesia with flurbiprofen axetil were significantly decreased in the QLB group (P＜0.05), and the incidence of adverse reactions at 48 hours after operation in the QLB group was significantly lower than that in the TAP group(P＜0.05). 
Conclusion Compared with transversus abdominis plane block, quadratus lumborum block has more perfect analgesic effect, longer action time and less opioid application, which is more suitable for multimodal analgesia after gynecological laparoscopic surgery.


Key words: ovarian neoplasms； laparoscopic, quadratus lumborum block, transversus abdominis plane block