Comparative Evaluation of Analgesic Efficacy and Recovery Outcomes: Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament Versus Transversus Abdominis Plane Block in Laparoscopic Partial Hepatectomy.

IF 1.2 4区 医学 Q3 SURGERY
Lingling Jiang, Yun Li, Kui Sheng, Lili Zhang, Yang Hu, Ye Zhang
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Abstract

Objective: A comparative assessment of analgesic effectiveness and recovery quality between the anterior quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) and the transversus abdominis plane block (TAPB) in patients undergoing laparoscopic partial hepatectomy (LPH).

Method: A total of 56 patients scheduled for LPH were randomly allocated to either the QLB-LSAL group or the TAPB group in a 1:1 ratio. Patients in the QLB-LSAL group received bilateral anterior quadratus lumborum block at the lateral supra-arcuate ligament, while those in the TAPB group received bilateral subcostal transversus abdominis plane block before surgery. The primary outcome was the morphine equivalent consumption (MEC) at 24 hours postoperatively. Secondary outcomes included MEC at 48 and 72 hours, as well as numeric rating scale (NRS) pain scores at rest and during movement, recorded at 2, 4, 6, 12, 24, and 48 hours postoperatively. The quality of recovery was assessed using QoR-15 scores, measured 1 day before surgery and on the first and third postoperative days.

Results: The QLB-LSAL group demonstrated significantly lower MEC at 24, 48, and 72 hours postoperatively compared with the TAPB group. NRS scores for pain at rest and during movement were also significantly lower in the QLB-LSAL group at 2, 4, 6, 12, and 24 hours following surgery. In addition, the QoR-15 scores, which assess the quality of recovery, were significantly higher in the QLB-LSAL group compared with the TAPB group on both the first and third postoperative days.

Conclusion: The QLB-LSAL method provides superior analgesia and enhances recovery quality compared with the TAPB approach in patients undergoing LPH.

腹腔镜肝部分切除术中腰前方肌外侧弓形上韧带阻滞与腹横面阻滞镇痛效果和恢复效果的比较评价。
目的:比较评价腹腔镜肝部分切除术(LPH)患者腰前方肌外侧弓上韧带阻滞(QLB-LSAL)与腹横平面阻滞(TAPB)的镇痛效果和恢复质量。方法:56例LPH患者按1:1的比例随机分为QLB-LSAL组和TAPB组。QLB-LSAL组术前行双侧前腰方肌外侧弓上韧带阻滞,TAPB组术前行双侧肋下腹横平面阻滞。主要观察指标为术后24小时吗啡当量消耗量(MEC)。次要结果包括48小时和72小时的MEC,以及在术后2、4、6、12、24和48小时记录休息和运动时的数字评定量表(NRS)疼痛评分。术前1天、术后第1天和第3天采用QoR-15评分评估恢复质量。结果:与TAPB组相比,QLB-LSAL组在术后24、48和72小时的MEC明显降低。在术后2、4、6、12和24小时,QLB-LSAL组休息和运动时疼痛的NRS评分也显著降低。此外,在术后第一天和第三天,QLB-LSAL组的QoR-15评分(评估恢复质量)均显著高于TAPB组。结论:与TAPB方法相比,QLB-LSAL方法在LPH患者中具有更好的镇痛效果,提高了恢复质量。
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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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