Ultrasound-guided transversalis fascia plane block versus transmuscular quadratus lumborum block for post-operative analgesia in inguinal hernia repair.
Ultrasound-guided transversalis fascia plane block versus transmuscular quadratus lumborum block for post-operative analgesia in inguinal hernia repair.
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DOI：
10.3344/kjp.2021.34.2.201
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发表时间：
2021-04-01
期刊：
影响因子：
--
通讯作者：
Mohammed HMES
中科院分区：
文献类型：
--
作者：
Fouad AZ;Abdel-Aal IRM;Gadelrab MRMA;Mohammed HMES
腹股沟疝修补术是最常用的外科手术之一。局部阻滞可提供良好的镇痛效果，减少术后并发症。我们的目的是比较超声引导下筋膜横肌（TF）平面阻滞与腰方肌（QL）阻滞在单侧腹股沟疝修补术中的术后镇痛效果。50名患者参加了这项比较研究，并被随机分为两组。一组接受超声引导的QL阻滞。另一组接受超声引导的TF平面阻滞。主要结果是术后30分钟用数字疼痛评定量表（NRS）评估患者静息和运动引起的疼痛。次要结局包括术后第一天接受抢救性镇痛的患者百分比、技术操作的难易程度和不良反应的发生率。两组术后24小时内休息和运动时的NRS无统计学差异。QL组术后30分钟内接受术后抢救镇痛药的患者比例为4% (n = 1)，而TF组为12% （n = 3）。但是，TF块的平均执行时间比QL块短，并且TF块的执行在技术上看起来更容易。超声引导的TF平面阻滞与QL阻滞在降低非复发性腹股沟疝修补术后疼痛评分和减少阿片类药物消耗方面同样有效。
Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block. In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following non-recurrent inguinal herniorrhaphy.
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