The Clinical Effect Observation Of Quadratus Lumborum Block For Postoperative Analgesia On PCNL

Objective: Quadratus lumborum block(QLB)belong to the trunk nerve block,can be used for postoperative analgesia of abdominal surgery,with the development of minimally invasive surgical cavity mirror technology,and to meet the requirements of rapid rehabilitation surgery concept,its clinical use more and more,this study investigates the QLB used for PCNL postoperative analgesia in patients with clinical effect observation.Methods :This study belong to prospective,randomized study.Selected 50 patients undergoing elective PCNL in July 2018 to October 2019 lines Guilin medical school affiliated hospital,American Society of Anesthesiologists(ASA)class I-II、any gender、weight 45-80 kg,divided into two groups by random number method,25 cases in each group.Group A for the control group,to routine tracheal intubation general anesthesia,group B as the experimental group,guided by ultrasound quadratus lumborum block before operation,the drugs use 20 ml Ropivacaine(0.375%).Records of the patient’s general information(gender、age、height、weight、ASA class),Compare two groups of patients 5 minutes before incision and at skin incision changes of blood pressure and heart;intraoperative sufentanil and fentanyl used total amount;after surgery 2 h(T1)、4 h(T2)、8 h(T3)、12 h(T4)、24 h(T5)、48 h(T6)resting pain score(VAS score)and Ramsay sedation scores;The number of cases of adverse reactions.Results: A、B two groups with no difference between the general data through statistical analysi;A、B two groups 5 minutes before incision and at skin incision blood pressure and heart rate changes significant difference,statistically significant(p < 0.05),Group A 5 minutes before incision and at skin incision blood pressure and heart rate fluctuations than group B;Intraoperative sufentanil using two groups with no significant differences in total,not statistically significant(p > 0.05),two groups with the use of fentanyl have significant differences in total,with statistical significance(p < 0.05),group A with the use of fentanyl total more than group B;Two groups with resting is the comparison of VAS score in T6 time has no obvious difference(p < 0.05),no statistical significance,but in T1、T3、T4 and T5 moment more obvious difference(p < 0.05),statistically significant,A group with VAS score in T1、T2、T3、T4 and T5 moment is higher than group B;Two groups at all time points of Ramsay sedation score was no significant difference(p < 0.05)Conclusions:Ultrasound guided quadratus lumborum block for PCNL can reduce patients who opioid usage,can reduce postoperative VAS score,postoperative analgesia has good clinical effect,can be used as multimodal analgesia after PCNL.