Evaluation on analgesic effect of ultrasound-guided quadrates lumborum block in patients undergoing rad-ical resection of rectal cancer / 临床麻醉学杂志

ABSTRACT

Objective To investigate the analgesia effects and duration ofultrasound-guided quadratus lumborum block (QLB)in radical resection of rectal cancer,and to evaluate its clinical effect, so as to provide new clinical ideas for intraoperative and postoperative analgesia. Methods Sixty patients who would undergo expected radical resection of transabdominal rectal cancer in our hospital from February,2016 to March,2017 were selected,of which 36 males and 24 fe-males,aged 30-70 years,ASA physical status Ⅰ or Ⅱ.They were randomly divided into two groups,30 cases in each.After induction,the patients in group QLB underwent ultrasound-guided bi-lateral QLB before surgury,40 ml of 0.375% ropivacaine was given to these patients.Patients in group C received general anesthesia alone.The values of systolic pressure (SBP),diastolic pressure (DBP),heart rate (HR)immediately before and 5 minutes after cutting were oberserved and recor-ded.The patients'incision reaction,the dosage of fentanyl intraoperative,the visual analogue scores (VAS)of 2,4,6,12,24,and 48 hours after operation,the first time pressing the analgesic pump button,the consumption of sufentanil,times of remedial analgesia,the time getting out of bed,the patient's satisfaction with postoperative analgesia were recorded in the two groups.Results The changes of SBP,DBP and HR 5 min before and after skin incision in group QLB were significantly lower than those in group C (P <0.05).The usage of fentanyl in group QLB significantly decreased compared with that in group C (P < 0.01 ).The first time pressing the analgesic pump button in group QLB was significantly later than that in group C (P <0.05).The usage of sufentanil signifi-cantly decreased in QLB group at 2,4,6,12 and 24 hours after operation compared with that in group C (P <0.05).The times of remedial analgesia in group QLB were lower than that in group C (P <0.05).The time getting out of bed and exhausting in group QLB were significantly earlier com-pared with those in group C (P <0.05).The patient's satisfaction with postoperative analgesia was significantly higher in group QLB compared with that in group C (P <0.05 ).Conclusion Bilateral quadratus lumborum blockage with 0.375% ropivacaine can reduce the opioid consumption for patients undergoing radical surgery of rectal cancer,and postoperative opioid usage was also reduced. The time getting out of the bed in group QLB was significantly shifted to an earlier date compared with those in group C.It can provide a satisfactory analgesia,and improve the patient's comfort and satisfaction.