Comparison of two approaches to quadratus lumborum block for postoperative analgesia in radical cystectomy: a randomized clinical trial.

IF 2.9 3区 医学 Q1 ANESTHESIOLOGY
Minerva anestesiologica Pub Date : 2025-01-01 Epub Date: 2024-12-10 DOI:10.23736/S0375-9393.24.18332-0
Ghada M Aboelfadl, Abdelraheem M Elawamy, Ahmed H Othman, Hassan M Abdelbaky, Ahmed M Aboelfadl, Marwa M Abdelrady
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引用次数: 0

Abstract

Background: The aim of this study was to evaluate the analgesic effects following radical cystectomy using two ultrasound guided quadratus lumborum block (QLB) techniques: anterior and intramuscular.

Methods: Sixty patients aged 40-60 years old with ASA I, II were considered for this study. They were divided into two equal groups. Bilateral ultrasound guided QLB was performed via either the anterior (QLBa) or intramuscular (QLBi) approach with 2.5 mg/kg of 0.25% bupivacaine diluted to 20 mL of normal saline after surgery. The primary outcome was the time to the first request for analgesia, while the secondary outcomes were the dose of postoperative morphine consumption, numerical rating scale (NRS) at rest and on movement, Bromage Scale, adverse events, and patient satisfaction.

Results: The mean time to first request for analgesia was significantly prolonged in group QLBa (14.7±1.33 hours) compared to group QLBi (9.8±0.72 hours) (P<0.001). NRS either at rest or on movement were not statistically significant until six hours postoperatively. At 10, 12, and 14 h, Group QLBi had a significantly higher NRS Score at rest and on movement (P<0.001). Group QLBa had a significantly lower total morphine consumption (5.37±0.49 mg) compared to Group QLBi (6.4±0.77 mg) (P<0.001). The QLBa had higher patient satisfaction than the QLBi.

Conclusions: Compared with QLBi, bilateral ultrasound guided QLBa provided a longer time to the first analgesic request, less postoperative opioid consumption, lower NRS at rest and on movement, and higher patients' satisfaction after radical cystectomy under general anesthesia.

两种入路腰方肌阻滞用于根治性膀胱切除术术后镇痛的比较:一项随机临床试验。
背景:本研究的目的是评估两种超声引导QLB技术(前路和肌内)根治性膀胱切除术后的镇痛效果。方法:60例年龄40 ~ 60岁的ASA I、II型患者作为研究对象。他们被分成两组。双侧超声引导QLB通过前路(QLBa)或肌内(QLBi)入路,术后用2.5 mg/kg 0.25%布比卡因稀释至20 mL生理盐水。主要结局是第一次请求镇痛的时间,次要结局是术后吗啡消耗剂量、静止和运动时的数值评定量表(NRS)、Bromage量表、不良事件和患者满意度。结果:与QLBi组(9.8±0.72小时)相比,QLBa组(14.7±1.33小时)平均首次请求镇痛时间明显延长(p结论:双侧超声引导下QLBa组比QLBi组(9.8±0.72小时)首次请求镇痛时间更长,术后阿片类药物消耗更少,静止和运动时NRS更低,全麻根治性膀胱切除术后患者满意度更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Minerva anestesiologica
Minerva anestesiologica 医学-麻醉学
CiteScore
4.50
自引率
21.90%
发文量
367
审稿时长
4-8 weeks
期刊介绍: Minerva Anestesiologica is the journal of the Italian National Society of Anaesthesia, Analgesia, Resuscitation, and Intensive Care. Minerva Anestesiologica publishes scientific papers on Anesthesiology, Intensive care, Analgesia, Perioperative Medicine and related fields. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors.
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