Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Children Undergoing Low Abdominal Surgery A Randomized Controlled Trial
Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Children Undergoing Low Abdominal Surgery A Randomized Controlled Trial
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DOI：
10.1097/aap.0000000000000645
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发表时间：
2017-09-01
影响因子：
5.1
通讯作者：
Oksuz, Hafize
中科院分区：
文献类型：
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作者：
Oksuz, Gozen;Bilal, Bora;Oksuz, Hafize
背景和目的：躯干阻滞在腹部外科多模式镇痛技术中占有一席之地。腰四头肌阻滞是一种新的腹部躯干阻滞，用于上腹部和下腹部的躯体镇痛。本研究采用前瞻性、双盲、随机对照研究方法，将53例单侧腹股沟疝修补术或固定术患儿随机分为腹方肌阻滞组和腹方肌平面阻滞组。所有阻滞均在术前全身麻醉下进行。疼痛程度使用Flacc(面部、腿部、活动、哭泣、可分离性)量表进行评估。结果：在排除3名不符合条件的患者后，这项研究纳入了50名患者。腰方肌阻滞组在术后24小时内需要止痛的患者数量显著减少(P<；0.05)。腰方肌阻滞组术后30min、1、2、4、6、12、24小时Flacc评分均低于腹侧平面阻滞组(P<；0.05)。腰方肌阻滞组的家长满意度得分高于腹方肌阻滞组(P<；0.05)。结论：在单侧腹股沟疝修补术或固定术的患儿中，腰方肌阻滞组的术后镇痛效果明显优于腹方肌阻滞组。
Background and Objectives: Truncal blocks have a place within multimodal analgesia techniques in abdominal surgery. The quadratus lumborum block is a new abdominal truncal block used for somatic analgesia of both the upper and lower abdomen. In this prospective, double-blind, randomized study, we aimed to compare quadratus lumborum block and transversus abdominis plane block in pediatric patients undergoing lower abdominal surgery.Methods: Fifty-three children undergoing unilateral inguinal hernia repair or orchiopexy surgery were randomized into 2 groups: transversus abdominis plane block and quadratus lumborum block. All blocks were performed under general anesthesia before surgery. Pain levels were assessed using an FLACC (Face, Legs, Activity, Cry, Consolability) scale.Results: The study included 50 patients, after excluding 3 patients who were not eligible. The number of patients who required analgesia in the first 24 hours postoperatively was significantly lower in the quadratus lumborum block group (P < 0.05). In the quadratus lumborum block group, the postoperative 30-minute and 1-, 2-, 4-, 6-, 12-, and 24-hour FLACC scores were lower compared with those of the transversus abdominis plane block group (P < 0.05). Parent satisfaction scores were higher in the quadratus lumborum block group (P < 0.05).Conclusions: The results of this study showed that in pediatric patients undergoing unilateral inguinal hernia repair or orchiopexy the quadratus lumborum block provided longer and more effective postoperative analgesia compared with the transversus abdominis plane block.