Ultrasound-guided Quadratus Lumborum Block Versus Transversus Abdominis Plane Block For Postoperative Pain After Open Colorectal Surgery

Objective:To observe the difference of ultrasound-guided quadratus lumborum block(QLB)and transversus abdominis plane block(TAPB)in analgesia after open colorectal surgery.Methods:Ninety-two patients(47 males,45 females,aged 18-65 years,BMI18.5-28kg/,ASA gradeⅠ-Ⅲ)scheduled for open colorectal surgery were randomlydivided into 3 groups:QLB group(group Q,n=31),TAPB group(group T,n=31),control group(group C,n=30).Patients in group Q and groupT were given ultrasound-guided QLB and TAPB before the induction of anesthesia with 0.5%ropivacaine 20 ml for each side respectively,while patients in group C were given general anesthesia simply.Each patient underwent patient-controlled intravenous analgesia(PCIA)postoperation.Pethidine 50 mg was given when Visual Analogue Scale/Score(VAS)pain score was higher than 4.In this study,we observed and recorded the hemodynamic change,the total consumption of sevoflurane,sufentanil and vasoactive agent during the operation.VAS pain scores were assessed at0,2,6,12,24,48 h after the operation.The first time of patient-controlled analgesia,the consumption of analgesic pump,the ratio of rescue-analgesia and postoperative nausea and vomiting(PONV),the recovery and the length of stay,and the degree of satisfaction of patients were also recorded.Results:Compared with group Q and group T,the change of MAP,HR 5 mins before and after skin incision,the consumption of sevoflurane and sufentanil during operation,the consumption of analgesic pump within 24 h postoperation,the VAS scores at T0~T4,the ratio of rescue-analgesia and PONV were significantly higher(P<0.05),the recover time and length of stay were significantly longer(P<0.05),the degree of satisfaction was significantly lower in group C(P<0.05).Compared with group T,the VAS scores at T2 and T3,the consumption of analgesic pump during0~6h,6~12h and 0~24h postoperatively,and the ratio of PONV were significantly lower(P<0.05),the first time of patient-controlled analgesia was significantly later(P<0.05),the degree of satisfaction was significantly lower in group Q(P<0.05).Conclusions:QLB can more effectively reduce the postoperative consumptionof opioids and adverse effects than TAPB,thus improving the comfort level.