背景:该研究旨在比较前方肌阻滞(QLB3)和竖脊肌平面阻滞(ESPB)的疼痛缓解效果,两者都被证明在腹部手术期间提供缓解。
方法:这项前瞻性观察研究,在2023年2月至7月间进行的研究中,96例患者接受了经皮肾镜取石术(PCNL).患者分为三组:QLB3,ESPB,和对照组(无阻滞),并在麻醉前室接受相应的神经阻滞进行区域阻滞。PCNL后最初24小时的累积吗啡消耗量,数字评分量表休息/运动分数,术中使用瑞芬太尼,抢救镇痛要求,第一次镇痛药被要求的时间,记录术后恶心和呕吐评分,并进行组间比较.
结果:QLB3和ESPB组术后前24小时吗啡总消耗中位数相似,但对照组更高(QLB3,7mg[(Q1-Q3)7-8.5];ESPB,8毫克[6.5-9];对照,12.5[10-17];P<0.001)。同样,术中瑞芬太尼消耗中位数在阻滞组之间没有差异,但对照组较高(QLB3,1082µg[IQR805.5-1292.7];ESPB,1278µg[940.2-1297.5];对照,1561µg[1315-2068];P<0.001)。阻滞组接受抢救镇痛药物的患者数量相似,但对照组较高(QLB3,n=9[30%];ESPB,n=14[46.7%];对照,n=21[70%];P=0.008)。
结论:QLB3和ESPB作为PCNL术后多模式镇痛的一部分,在提供术后镇痛方面是充分和可比的。
背景:该研究已在ClinicalTrials.gov上注册(标识符:NCT05822492)。
BACKGROUND: The study aimed to compare the pain-relieving effectiveness of anterior quadratus lumborum block (QLB3) and erector spinae plane block (ESPB), both of which have been documented to provide relief during abdominal surgery.
METHODS: This prospective observational study, conducted between February and July 2023, included 96 patients who had undergone percutaneous nephrolithotomy (PCNL). Patients were divided into three groups: QLB3, ESPB, and control (no block) and received the corresponding nerve block in the preanesthetic room for regional block. Cumulative morphine consumption during the initial 24 h after PCNL, numerical rating scale resting/movement scores, intraoperative remifentanil usage, rescue analgesic requirements, time when the first analgesic was requested, and postoperative nausea and vomiting scores were documented and compared between the groups.
RESULTS: Total median morphine consumption in the first 24 h postoperatively was similar in the QLB3 and ESPB groups but higher in the control group (QLB3, 7 mg [(Q1-Q3) 7-8.5]; ESPB, 8 mg [6.5-9]; control, 12.5 [10-17]; P < 0.001). Similarly, median intraoperative remifentanil consumption did not differ between the block groups but was higher in the control group (QLB3, 1082 µg [IQR 805.5-1292.7]; ESPB, 1278 µg [940.2-1297.5]; control, 1561 µg [1315-2068]; P < 0.001). The number of patients receiving rescue analgesic medication was similar in the block groups but higher in the control group (QLB3, n = 9 [30%]; ESPB, n = 14 [46.7%]; control, n = 21 [70%]; P = 0.008).
CONCLUSIONS: QLB3 and ESPB were adequate and comparable in providing postoperative analgesia as part of multimodal analgesia after PCNL.
BACKGROUND: The study was registered on ClinicalTrials.gov (Identifier: NCT05822492).