Comparison of postoperative analgesia among the three different regional anesthesia methods for the patients undergoing laparoscopic radical colorectal cancer surgery
Objective:To compare the postoperative incisional and visceral pain among local infiltration analgesia(LIA),transver-sus abdominis plane block(TAPB)and quadratus lumborum block(QLB)for the patients undergoing laparoscopic radical col-orectal cancer surgery.Methods:123 patients admitted to Funing People's Hospital from February 2020 to March 2024,who underwent laparoscopic radical colorectal cancer surgery,age of 30 years or over,ASA physical status Ⅰ-Ⅲ,were randomly divided into LIA group(42 cases),TAPB group(42 cases),and QLB group(39 cases).The LIA group received incision infiltra-tion layer by layer at the incision with 0.375％ropivacaine 40 mL during skin suture;the TAPB group received 0.375％ropi-vacaine 20 mL on each side for transversus abdominis plane block,a total amount of 40 mL;the QLB group received 0.375％ropivacaine 20 mL on each group for quadratus lumborum block,a total amount of 40 mL.Visual analogue score(VAS)was used to evaluate the incisional and visceral pain of the patients at 20 min after extubation,and 2,4,8,12,24 h after operation.The occurrence of adverse reactions in three groups was observed within 24 h,including bradycardia,itching,sleepiness,dizziness,nausea and vomiting.Results:There were no significant differences about the age,gender,ASA classification,BMI,intraoperative fentanil dose,and awakening time among the three groups(all P＞0.05).The incisional pain-related resting VAS scoring of TAPB group at 12 h(P=0.007)after operation was significant difference compared with the LIA group.The incisional pain-related resting VAS scoring of QLB group at 8 h(P＜0.001),12 h(P=0.001)after operation were significant difference compared with the LIA group.The visceral pain-related resting VAS scoring of QLB group were decreased slightly at 20 min after extubation(P＜0.001,P=0.010),and 2 h after operation(P=0.007,0.022)than the LIA group and TAPB group.There were no significant differences in adverse reactions among the three groups(P＞0.05).Conclusion:QLB provides a lasting and satisfac-tory incisional and visceral pain-related analgesic effect than the LI A and TAPB for the patients undergoing laparoscopic radical colorectal cancer surgery.
laparoscopic radical resection of colorectal cancerquadratus lumborum blockincisional painvisceral pain
万方数据
维普
