{"title":"超声引导下腰方肌阻滞和腰丛阻滞在髋关节镜检查中的比较疗效分析:一项前瞻性随机对照试验。","authors":"Liangjing Yuan, Chengshi Xu, Ye Zhang, Geng Wang","doi":"10.1093/jhps/hnac020","DOIUrl":null,"url":null,"abstract":"<p><p>Controlled trials assessing quadratus lumborum block (QLB) for post-operative analgesia in hip surgery are scarce. This study aimed to compare ultrasound-guided QLB and lumbar plexus block (LPB) for clinical efficacy in hip arthroscopy. Patients undergoing hip arthroscopy in Beijing Jishuitan Hospital in January-June 2019 were randomized to the lumbar plexus (L) and quadratus lumborum (Q) groups (<i>n</i> = 25/group). After either ultrasound-guided block for 30 min, both groups were prepared for surgery after muscle strength measurement in the affected limbs. Opioid doses for patient-controlled analgesia (PCA), visual analog scale (VAS) scores in the resting and active states, upon leaving the post-anesthesia care unit (PACU), and at 2-48 h post-surgery were recorded, and post-operative complications were also recorded. Muscle strength in the affected limbs was significantly higher in the Q group compared with the L group (4.0 versus 2.0, <i>P</i> < 0.001). VAS scores were similar in both groups post-surgery (<i>P</i> > 0.05). One patient had epidural spread in the L group, with no other complications. Compared with ultrasound-guided LPB, ultrasound-guided QLB provides similar and good post-operative analgesia after hip arthroscopy, with less impact on muscle strength and fewer complications. These results should be confirmed in larger trials.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"9 2","pages":"119-125"},"PeriodicalIF":1.4000,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291388/pdf/","citationCount":"3","resultStr":"{\"title\":\"Comparative efficacy analysis of ultrasound-guided quadratus lumborum block and lumbar plexus block in hip arthroscopy: a pilot prospective randomized controlled trial.\",\"authors\":\"Liangjing Yuan, Chengshi Xu, Ye Zhang, Geng Wang\",\"doi\":\"10.1093/jhps/hnac020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Controlled trials assessing quadratus lumborum block (QLB) for post-operative analgesia in hip surgery are scarce. This study aimed to compare ultrasound-guided QLB and lumbar plexus block (LPB) for clinical efficacy in hip arthroscopy. Patients undergoing hip arthroscopy in Beijing Jishuitan Hospital in January-June 2019 were randomized to the lumbar plexus (L) and quadratus lumborum (Q) groups (<i>n</i> = 25/group). After either ultrasound-guided block for 30 min, both groups were prepared for surgery after muscle strength measurement in the affected limbs. Opioid doses for patient-controlled analgesia (PCA), visual analog scale (VAS) scores in the resting and active states, upon leaving the post-anesthesia care unit (PACU), and at 2-48 h post-surgery were recorded, and post-operative complications were also recorded. Muscle strength in the affected limbs was significantly higher in the Q group compared with the L group (4.0 versus 2.0, <i>P</i> < 0.001). VAS scores were similar in both groups post-surgery (<i>P</i> > 0.05). One patient had epidural spread in the L group, with no other complications. Compared with ultrasound-guided LPB, ultrasound-guided QLB provides similar and good post-operative analgesia after hip arthroscopy, with less impact on muscle strength and fewer complications. These results should be confirmed in larger trials.</p>\",\"PeriodicalId\":48583,\"journal\":{\"name\":\"Journal of Hip Preservation Surgery\",\"volume\":\"9 2\",\"pages\":\"119-125\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2022-03-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291388/pdf/\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hip Preservation Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/jhps/hnac020\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hip Preservation Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jhps/hnac020","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/7/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 3
摘要
评估腰方肌阻滞(QLB)用于髋关节手术后镇痛的对照试验很少。本研究旨在比较超声引导下QLB与腰丛阻滞(LPB)在髋关节镜检查中的临床疗效。2019年1 - 6月在北京积水潭医院行髋关节镜检查的患者随机分为腰丛组(L)和腰方肌组(Q),每组25例。超声引导阻滞30 min后,测量患肢肌力后,两组均准备手术。记录患者自控镇痛(PCA)阿片类药物剂量、静息状态、活动状态、离开麻醉后护理单元(PACU)及术后2 ~ 48 h视觉模拟评分(VAS),并记录术后并发症。Q组患肢肌力明显高于L组(4.0比2.0,P P > 0.05)。L组1例患者出现硬膜外扩散,无其他并发症。与超声引导下的LPB相比,超声引导下的QLB在髋关节镜术后镇痛效果相似且良好,对肌力的影响较小,并发症较少。这些结果应该在更大规模的试验中得到证实。
Comparative efficacy analysis of ultrasound-guided quadratus lumborum block and lumbar plexus block in hip arthroscopy: a pilot prospective randomized controlled trial.
Controlled trials assessing quadratus lumborum block (QLB) for post-operative analgesia in hip surgery are scarce. This study aimed to compare ultrasound-guided QLB and lumbar plexus block (LPB) for clinical efficacy in hip arthroscopy. Patients undergoing hip arthroscopy in Beijing Jishuitan Hospital in January-June 2019 were randomized to the lumbar plexus (L) and quadratus lumborum (Q) groups (n = 25/group). After either ultrasound-guided block for 30 min, both groups were prepared for surgery after muscle strength measurement in the affected limbs. Opioid doses for patient-controlled analgesia (PCA), visual analog scale (VAS) scores in the resting and active states, upon leaving the post-anesthesia care unit (PACU), and at 2-48 h post-surgery were recorded, and post-operative complications were also recorded. Muscle strength in the affected limbs was significantly higher in the Q group compared with the L group (4.0 versus 2.0, P < 0.001). VAS scores were similar in both groups post-surgery (P > 0.05). One patient had epidural spread in the L group, with no other complications. Compared with ultrasound-guided LPB, ultrasound-guided QLB provides similar and good post-operative analgesia after hip arthroscopy, with less impact on muscle strength and fewer complications. These results should be confirmed in larger trials.