The Effect of Different Surgical Approaches of Ultrasound-Guided Quadratus Lumborum Block on the Analgesic Effect in Cesarean Section

Abstract

To study the effect of different surgical approaches of ultrasound-guided quadratus lumborum block on the analgesic effect in cesarean section. Methods 150 parturients underwent elective caesarean section in our hospital from February 2017 to February 2020 were enrolled in this study. They were divided into observation group and control group according to the method of random number table, with 75 cases in each group. In control group, anterior QLB was used, while in observation group, posterior QLB was used. The operation process was performed by the same anesthesiologist. If the injection situation was not ideal, the position of needle tip was timely adjusted. Both groups were given sufentanil 100 μg/kg (diluted with 100 mL normal saline) and a single addition of morphine 50 mg (diluted with 100 mL normal saline) for self-controlled analgesia after operation. The postoperative time to first water intake, the time to first discharge from bed, hospital stay and satisfaction degree of labor pain were compared between the two groups. The numerical pain score (NRS) and visual analogue scale (VAS) scores of rest and movement at different time after operation were compared. The dosage of sufentanil and morphine in perioperative period and the occurrence of postoperative adverse reactions were compared between the two groups. Results The time to first water intake, the time to first discharge from bed and hospital stay in the observation group were significantly shorter than those in the control group (P< 0.05), and the satisfaction score of analgesia in the observation group was significantly higher than that in the control group (P< 0.05). The NRS score of observation group at T0, 1, 2, 3 and 4 after operation was significantly lower than that of control group (P< 0.05). There was no significant difference in VAS score of rest and movement at 4 and 8 h after operation between the two groups (P> 0.05); the VAS score of rest and movement at 12 and 24 h after operation in observation group was significantly lower than that in control group (P< 0.05). The amount of sufentanil and morphine used in the perioperative period in the observation group was significantly less than that in the control group (P< 0.05). The total incidence rate of adverse reactions in observation group was not significantly different from that in control group (P> 0.05). Conclusion Both anterior and posterior QLB can provide analgesia after cesarean section, but posterior QLB can better relieve the postoperative pain of parturients, which is worth popularizing in clinic.