Objectives Transmuscular quadratus lumborum block(TQLB)may provide postoperative analgesia in patients undergoing intraperitoneal surgeries.The purpose of this study was to examine the potential efficacy of TQLB among...Objectives Transmuscular quadratus lumborum block(TQLB)may provide postoperative analgesia in patients undergoing intraperitoneal surgeries.The purpose of this study was to examine the potential efficacy of TQLB among patients undergoing retroperitoneal procedures,such as the laparoscopic partial nephrectomy(LPN).Methods This prospective,randomized,controlled study was conducted from August 2017 to November 2018 at Peking Union Medical College Hospital(Beijing,China).Patients who were scheduled for a LPN,aged 18・70 years old with an ASA physical status score of I-II were randomly assigned to receive either TQLB with 0.6 ml/kg of 0.5%ropivacaine plus general anesthesia(TQLB group)or general anesthesia alone(control group).Patient-controlled intravenous analgesia with morphine was initiated immediately upon surgery completion.The primary outcome was the cumulative consumption of morphine within 8 h after surgery.The secondary outcome included postoperative consump廿ons of morphine at other time points,pain score at rest and during activity,postoperative nausa and vomitting(PONV),and recovery related parameters.Results Totally 30 patients per group were recruited in the study.The 8 h consumption of morphine was lower in theTQLB group than in the control group(median,0.023 mg/kg vs.0.068 mg/kg,U=207.5,P<0.001).No significant differences were observed in postoperative pain scores between the two groups.Patients in the TQLB group had fewer episodes of PONV(20%vs.47%,χ2=4.&P=0.028)in the first 24 h after surgery and higher scores for quality of recovery(mean,13&6 vs.131.9,t=-2.164,P=0.035)120 h after surgery than the controls.Conclusions TQLB resulted in an opioid-sparing effect during the early postoperative period following LPN,as well as a lower incidence of PONV and improved quality of recovery.展开更多
Background Ultrasound-guided continuous thoracic paravertebral block can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy.We hypothesize that these effects may improve the quali...Background Ultrasound-guided continuous thoracic paravertebral block can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy.We hypothesize that these effects may improve the quality of recovery(QoR)after open hepatectomy.Methods Seventy-six patients undergoing open hepatectomy were randomized to receive a continuous thoracic paravertebral block with ropivacaine(CTPVB group)or normal saline(control group).All patients received patient-controlled intravenous analgesia with morphine postoperatively for 48 hours.The primary outcome was the global Chinese 15-item Quality of Recovery score on postoperative day 7,which was statistically analyzed using Student’s t-test.Results Thirty-six patients in the CTPVB group and 37 in the control group completed the study.Compared to the control group,the CTPVB group had significantly increased global Chinese 15-item Quality of Recovery scores(133.14±12.97 vs.122.62±14.89,P=0.002)on postoperative day 7.Postoperative pain scores and cumulative morphine consumption were significantly lower for up to 8 and 48 hours(P<0.05;P=0.002),respectively,in the CTPVB group.Conclusion Perioperative CTPVB markably promotes patient’s QoR after open hepatectomy with a profound analgesic effect in the early postoperative period.展开更多
文摘Objectives Transmuscular quadratus lumborum block(TQLB)may provide postoperative analgesia in patients undergoing intraperitoneal surgeries.The purpose of this study was to examine the potential efficacy of TQLB among patients undergoing retroperitoneal procedures,such as the laparoscopic partial nephrectomy(LPN).Methods This prospective,randomized,controlled study was conducted from August 2017 to November 2018 at Peking Union Medical College Hospital(Beijing,China).Patients who were scheduled for a LPN,aged 18・70 years old with an ASA physical status score of I-II were randomly assigned to receive either TQLB with 0.6 ml/kg of 0.5%ropivacaine plus general anesthesia(TQLB group)or general anesthesia alone(control group).Patient-controlled intravenous analgesia with morphine was initiated immediately upon surgery completion.The primary outcome was the cumulative consumption of morphine within 8 h after surgery.The secondary outcome included postoperative consump廿ons of morphine at other time points,pain score at rest and during activity,postoperative nausa and vomitting(PONV),and recovery related parameters.Results Totally 30 patients per group were recruited in the study.The 8 h consumption of morphine was lower in theTQLB group than in the control group(median,0.023 mg/kg vs.0.068 mg/kg,U=207.5,P<0.001).No significant differences were observed in postoperative pain scores between the two groups.Patients in the TQLB group had fewer episodes of PONV(20%vs.47%,χ2=4.&P=0.028)in the first 24 h after surgery and higher scores for quality of recovery(mean,13&6 vs.131.9,t=-2.164,P=0.035)120 h after surgery than the controls.Conclusions TQLB resulted in an opioid-sparing effect during the early postoperative period following LPN,as well as a lower incidence of PONV and improved quality of recovery.
文摘Background Ultrasound-guided continuous thoracic paravertebral block can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy.We hypothesize that these effects may improve the quality of recovery(QoR)after open hepatectomy.Methods Seventy-six patients undergoing open hepatectomy were randomized to receive a continuous thoracic paravertebral block with ropivacaine(CTPVB group)or normal saline(control group).All patients received patient-controlled intravenous analgesia with morphine postoperatively for 48 hours.The primary outcome was the global Chinese 15-item Quality of Recovery score on postoperative day 7,which was statistically analyzed using Student’s t-test.Results Thirty-six patients in the CTPVB group and 37 in the control group completed the study.Compared to the control group,the CTPVB group had significantly increased global Chinese 15-item Quality of Recovery scores(133.14±12.97 vs.122.62±14.89,P=0.002)on postoperative day 7.Postoperative pain scores and cumulative morphine consumption were significantly lower for up to 8 and 48 hours(P<0.05;P=0.002),respectively,in the CTPVB group.Conclusion Perioperative CTPVB markably promotes patient’s QoR after open hepatectomy with a profound analgesic effect in the early postoperative period.
