ABSTRACT
Objective To observe the difference of quadratus lumborum block (QLB)and transversus abdominis plane (TAP)block combined with patient controlled intravenous analgesia with sufentanil in analgesia after appendectomy.Methods Seventy-seven patients undergoing appendecto-my,including 44 patients males and 33 patients females,all falling into ASA Ⅰ or Ⅱ,were random-ized into group QLB (n =39)and group TAP block (n =38).Ultrasound-guided QLB and TAP block was performed at the end of operation and 0.25% ropivacaine hydrochloride 20 ml was used.Postop-erative VAS score and the consumption of sufentanil at 4,8,12,24 and 48 h was recorded.Postoper-ative nausea and vomiting,dizziness,skin itching were recorded.Results Patients in group QLB used significantly less sufentanil than that of group TAP (P <0.05 )at 12,24,48 h and VAS score has no differences after operation.Side effects like postoperative nausea and vomiting [2(5.1%)vs 8(21.0%)], and dizziness [4(10.2%)vs 11(28.9%)]were significantly less (P <0.05).Conclusion QLB can more effectively reduce postoperative sufentanil consumption and side effect than TAP block.
ABSTRACT
Objective To compare the difference of ultrasound-guided anterior sciatic nerve block by multiple injection and single injection.Methods Among 90 patients undergoing lower limb operation,aged 18-68 years old,47 patients were males and 43 patients were females,all falling into ASA Ⅰ-Ⅲ.The patients were randomized to ultrasound-guided anterior sciatic nerve block by multiple injection (group M,n=45) single injection (group S,n=45).Local anesthetic of 0.5% ropivacaine hydrochloride 20 ml was used.The width,thickness and depth of sciatic nerve and blocking performance time were recorded.Sensory and motor blockade on the operated limb were evaluated every 10 minutes after injection of local anesthetic for 30 minutes and complications were observed in two groups.Results The width,thinkness and depth of sciatic nerve on the ultrasound screen were not statistically significant in the two groups.The performance time of group M was longer than that of group S (P<0.05).The proportion of patients with sensory blockade of each nerve significantly differed between the two groups: for superficial peroneal nerve at 10,20,and 30 minutes,for the sural nerve at 20,30 minutes,for the tibial nerve at 30 minutes,that of group M was higher than that of group S (P<0.05).A significantly greater rate of motor blockade was observed for the dorsal flexion of foot and toes extension in group M than that of group S at 30 minutes (P<0.05).The complications of nausea,vomitting and tinnitus were not different in two groups.Conclusion Multiple injection needs more operation time compared with single injection,but its onset time of sensory and motor blockade is quicker,the complications were not different.