Abstract：
OBJECTIVE: To determine if single-injection bilateral posterior quadratus lumborum block (QLB) with ropivacaine would improve postoperative analgesia in the first 24 h after laparoscopic hepatectomy, compared with 0.9% saline.
METHODS: Prospective, double blinded, randomized controlled trial.
METHODS: A single tertiary care center from November 2021 and January 2023.
METHODS: A total of 94 patients scheduled to undergo laparoscopic hepatectomy due to hepatocellular carcinoma.
METHODS: Ninety-four patients were randomized into a QLB group (receiving 20 mL of 0.375% ropivacaine on each side, 150 mg in total) or a control group (receiving 20 mL of 0.9% saline on each side).
METHODS: The primary outcome was the cumulative opioid consumption during the initial 24-h post-surgery. Secondary outcomes included pain scores and intraoperative and recovery parameters.
RESULTS: The mean cumulative opioid consumption during the initial 24-h post-surgery was 30.8 ± 22.4 mg in the QLB group (n = 46) and 34.0 ± 19.4 mg in the control group (n = 46, mean differences: -3.3 mg, 95% confidence interval, -11.9 to 5.4, p = 0.457). The mean resting pain score at 1 h post-surgery was significantly lower in the QLB group than in the control group (5 [4-6.25] vs. 7 [4.75-8], p = 0.035). No significant intergroup differences were observed in the resting or coughing pain scores at other time points or in other secondary outcomes.
CONCLUSIONS: Preoperative bilateral posterior QLB did not reduce cumulative opioid consumption during the first 24 h after laparoscopic hepatectomy.
METHODS: Prospective, double blinded, randomized controlled trial.
METHODS: A single tertiary care center from November 2021 and January 2023.
METHODS: A total of 94 patients scheduled to undergo laparoscopic hepatectomy due to hepatocellular carcinoma.
METHODS: Ninety-four patients were randomized into a QLB group (receiving 20 mL of 0.375% ropivacaine on each side, 150 mg in total) or a control group (receiving 20 mL of 0.9% saline on each side).
METHODS: The primary outcome was the cumulative opioid consumption during the initial 24-h post-surgery. Secondary outcomes included pain scores and intraoperative and recovery parameters.
RESULTS: The mean cumulative opioid consumption during the initial 24-h post-surgery was 30.8 ± 22.4 mg in the QLB group (n = 46) and 34.0 ± 19.4 mg in the control group (n = 46, mean differences: -3.3 mg, 95% confidence interval, -11.9 to 5.4, p = 0.457). The mean resting pain score at 1 h post-surgery was significantly lower in the QLB group than in the control group (5 [4-6.25] vs. 7 [4.75-8], p = 0.035). No significant intergroup differences were observed in the resting or coughing pain scores at other time points or in other secondary outcomes.
CONCLUSIONS: Preoperative bilateral posterior QLB did not reduce cumulative opioid consumption during the first 24 h after laparoscopic hepatectomy.
摘要：
目的：确定罗哌卡因单次注射双侧后方肌阻滞（QLB）是否可以改善腹腔镜肝切除术后最初24h的术后镇痛效果。与0.9%盐水相比。
方法：前瞻性，双盲,随机对照试验。
方法：从2021年11月到2023年1月建立一个单一的三级护理中心。
方法：共有94例因肝细胞癌而计划进行腹腔镜肝切除术的患者。
方法：将94例患者随机分为QLB组（每侧接受20mL0.375％罗哌卡因，总共150毫克）或对照组（每侧接受20毫升0.9％盐水）。
方法：主要结果是术后最初24小时内的累积阿片类药物消耗量。次要结果包括疼痛评分和术中和恢复参数。
结果：QLB组（n=46）术后24小时的平均累积阿片类药物消耗量为30.8±22.4mg，对照组为34.0±19.4mg（n=46，平均差异：-3.3mg，95%置信区间,-11.9至5.4，p=0.457）。QLB组术后1h的平均静息疼痛评分明显低于对照组（5[4-6.25]vs.7[4.75-8],p=0.035)。在其他时间点或其他次要结局中，静息或咳嗽疼痛评分未观察到显着的组间差异。
结论：术前双侧后QLB没有减少腹腔镜肝切除术后最初24小时内的累积阿片类药物消耗量。
方法：前瞻性，双盲,随机对照试验。
方法：从2021年11月到2023年1月建立一个单一的三级护理中心。
方法：共有94例因肝细胞癌而计划进行腹腔镜肝切除术的患者。
方法：将94例患者随机分为QLB组（每侧接受20mL0.375％罗哌卡因，总共150毫克）或对照组（每侧接受20毫升0.9％盐水）。
方法：主要结果是术后最初24小时内的累积阿片类药物消耗量。次要结果包括疼痛评分和术中和恢复参数。
结果：QLB组（n=46）术后24小时的平均累积阿片类药物消耗量为30.8±22.4mg，对照组为34.0±19.4mg（n=46，平均差异：-3.3mg，95%置信区间,-11.9至5.4，p=0.457）。QLB组术后1h的平均静息疼痛评分明显低于对照组（5[4-6.25]vs.7[4.75-8],p=0.035)。在其他时间点或其他次要结局中，静息或咳嗽疼痛评分未观察到显着的组间差异。
结论：术前双侧后QLB没有减少腹腔镜肝切除术后最初24小时内的累积阿片类药物消耗量。
