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| Comparison of the anesthetic effect of the quadratus lumborum block by lateral supra-arcuate ligament and anterior quadratus lumborum block during the total laparoscopic hysterectomy |
| Huangshan People's Hospital, Huangshan, Anhui Province, 245000 |
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Abstract To compare the anesthetic effect of the quadratus lumborum block by lateral supra-arcuate ligament (QLB-LSAL) and anterior quadratus lumborum block (QLB) during the total laparoscopic hysterectomy. Methods: 80 patients who had been elective total laparoscopic hysterectomy between January 2019 and October 2021 were selected retrospectively. According to the different block methods, these patients were divided into group A (49 patients with QLB-LSAL) and group B (31 patients with anterior QLB). The perioperative indexes of the patients in both groups were recorded. The scores of visual analogue scale (VAS) of the patients at rest and action states in different time points after surgery were compared between the two groups. The changes of the values of heart rate (HR) and mean arterial pressure (MAP) of the patients before and after skin incision, and the occurrence of adverse events of the patients were compared between the two groups. Results: There was no significant difference in the incidence of adverse events (8.2% vs. 12.9%) of the patients between the two groups (P＞0.05). The onset time of block (6.58±2.24min), the first time of getting out of bed (13.04±2.12h), and the duration of hospital stay (9.14±0.86d) of the patients in group A were significantly shorter than those (9.78±3.07min, 16.69±2.64h, and 9.57±0.35d) of the patients in group B (P<0.05). However, there was no significant difference in the time of block operation of the patients between the two groups (P＞0.05). The VAS scores of the patients in the two groups at rest and action states in 2h, 6h, and 12h after surgery had increased gradually, but which of the patients in group A were significantly lower than those of the patients in group B (P<0.05). There were no significant differences in the MAP and HR values of the patients at 5min before skin incision between the two groups (P＞0.05). The values of MAP (90.33±8.91 mmHg) and HR (78.96±6.37 times/min) of the patients in group A at 5min after skin incision were significantly lower than those (96.42±9.04 mmHg and 84.61±6.15 times/min) of the patients in group B (P<0.05). Conclusion: Compared with those of anterior QLB, QLB-LSAL used in total laparoscopic hysterectomy of the patients has better analgesic effect, which can maintain the hemodynamic stability, optimize perioperative indexes, and promote the postoperative recovery anterior.
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