中国医学创新2025，Vol.22Issue(20)：10-15,6.DOI:10.3969/j.issn.1674-4985.2025.20.003
超声引导下不同入路腰方肌阻滞在老年腹腔镜胆囊切除术中的应用效果比较
Comparison of the Application Effect of Different Approaches of Quadratus Lumborum Block under Ultrasound Guidance in Elderly Laparoscopic Cholecystectomy
摘要
Abstract
Objective:To compare the application effects of different approaches of quadratus lumborum block under ultrasound guidance in elderly laparoscopic cholecystectomy.Method:A total of 120 elderly patients with benign gallbladder diseases scheduled for laparoscopic cholecystectomy at Yueqing People's Hospital from December 2022 to December 2023 were selected,they were randomly divided into group A and group B,with 60 cases in each group.Before anesthesia induction,under ultrasound guidance,group A received a transarcuate ligament quadratus lumborum block,while group B underwent an anterior quadratus lumborum block,both with 20 mL of 0.25%Ropivacaine.During the operation,both groups were induced with Sufentanil,Propofol,and Rocuronium,maintained with Remifentanil,Propofol,and Rocuronium,and received patient-controlled intravenous analgesia with Sufentanil after surgery.The operation time,postoperative anal exhaust time,ambulation time,number of rescue analgesia,hospital stay,block operation time,block onset time,number of block plane segments at different time points after block,heart rate and mean arterial pressure monitored at admission,before skin incision,and 3 minutes after pneumoperitoneum,cumulative consumption of Sufentanil at different time points after surgery,VAS score at rest,and incidence of postoperative anesthesia-related adverse reactions were recorded and compared between the two groups.Result:There were no statistically significant differences in operation time,time to first flatus,and hospital stay between group A and group B(P>0.05).Group A exhibited earlier postoperative ambulation time and fewer rescue analgesia episodes than group B(P<0.05).The onset time of block was shorter in group A,and the number of blocked dermatomal segments at 5 and 10 min post-block were significantly greater than those in group B(P<0.05).At 3 minutes after pneumoperitoneum,the heart rate in group A was slower and the mean arterial pressure was lower than those in group B(P<0.05).The cumulative consumption of Sufentanil at 24 hours after surgery in group A was less than that in group B(P<0.05).The VAS scores at rest at 2,6,and 12 hours after surgery in group A were lower than those in group B(P<0.05).The incidence of anesthesia-related adverse reactions in group A was 8.33%,significantly lower than 21.67%in group B(P<0.05).Conclusion:Ultrasound-guided transarcuate ligament quadratus lumborum block is more effective than anterior quadratus lumborum block,which can improve the analgesic effect after laparoscopic cholecystectomy in elderly patients,promote postoperative recovery and reduce the incidence of adverse reactions.关键词
老年/腹腔镜胆囊切除术/弓状韧带/腰方肌/镇痛Key words
Old age/Laparoscopic cholecystectomy/Arcuate ligament/Quadratus lumborum/Analgesia引用本文复制引用
卢泱,赵双瓯..超声引导下不同入路腰方肌阻滞在老年腹腔镜胆囊切除术中的应用效果比较[J].中国医学创新,2025,22(20):10-15,6.基金项目
温州市科研项目(经费自筹)(Y2023978) （经费自筹）
