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| Effects of ultrasound-guided quadratus lumborum block during laparoscopic myomectomy of patients on their Ramsay sedation score, serum norepinephrine level, and recovery quality |
| Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030 |
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Abstract To investigate the effects of ultrasound-guided quadratus lumborum block (QLB) during laparoscopic myomectomy (LM) of patients on their Ramsay sedation score, serum norepinephrine (NE) level, and recovery quality. Methods: A total of 104 patients who wanted LM were selected and divided into two groups (52 cases in each group) according to the random number table method from May 2019 to August 2021. The patients in the control group received total intravenous anesthesia, and the patients in the study group received QLB by ultrasound guidance firstly and then received total intravenous anesthesia. The levels of serum stress indicators, such as cortisol (Cor) and norepinephrine (NE), the scores of Visual Analogue Scale (VAS) and sedative Ramsay at different time points, the recovery quality, and the incidence of adverse reactions of the patients were compared between the two groups. Results: The levels of Cor and NE of the patients in both groups from 10 min after pneumoperitoneum to 24 h after surgery had increased continuously, but which of the patients in the study group were significantly lower than those of the patients in the control group (all P<0.05). The rest VAS score of the patients in the two groups in 6-24 h after surgery had decreased firstly and then increased, while Ramsay score of the patients in the two groups in 6-24 h after surgery had increased gradually. VAS score of the patients in the study group at 6 h, 12 h, or 24 h after surgery was significantly lower than that of the patients in the control group. The Ramsay scores of the patients in the study group at 6 h, 12 h, and 24 h after surgery (2.32±0.56 points, 2.49±0.53 points, and 2.64±0.46 points) were significantly higher than those (1.57±0.42 points, 1.68±0.38 points, and 1.82±0.43 points) of the patients in the control group (all P<0.05). The time from called to eye opening (6.69±0.83 min), the extubation time (8.17±1.14 min), and the wake time (26.45±4.93 min) of the patients in the study group were significantly shorter than those (7.95±0.91 min, 9.35±1.68 min, and 32.16±6.22 min) of the patients in the control group. The incidence of postoperative adverse reactions (5.8%) of the patients in the study group was significantly lower than that (21.2%) of the patients in the control group (P<0.05). Conclusion: The implementation of ultrasound-guided QLB for the patients during LM can significantly improve their analgesic and sedative effects, effectively reduce their stress state, improve their quality of recovery, with higher medicinal safety.
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