Effect Of Nalbuphine Combined With Ropivacaine In Ultrasound-guided Transmuscular Quadratus Lumborum Block On Inflammatory Cytokine Levels And Postoperative Analgesia In Patients Undergoing Retroperitoneal Laparoscopic Nephrectomy

Objective: To evaluate the effect of nalbuphine combined with ropivacaine in ultrasound-guided transmuscular quadratus lumborum block on inflammatory cytokine levels and postoperative analgesia in patients undergoing retroperitoneal laparoscopic nephrectomy.Methods: Eighty patients scheduled for retroperitoneal laparoscopic nephrectomy were randomly divided into two groups(n=40),group NQ and group Q.Ultrasound guided QLB was performed on the side of the operation after general anesthesia,group NQ received 0.4 ml/kg of 0.33% ropivacaine and 10 mg nalbuphine(diluted in 2 ml 0.9% saline),and group Q received 0.4 ml/kg of 0.33% ropivacaine and 2 ml 0.9% saline.Postoperatively,a patientcontrolled intravenous analgesic pump with sufentanil was attached to all the patients.The remifentanil and propofol consumption intraoperatively were compared.Plasma levels of IL-6,TNF-α and IL-10 were compared at 1 day before operation(T0),2 hours(T1),6 hours(T2),12 hours(T3)and 24 hours(T4)after operation.The VAS and Ramsay score was recorded at T1～T4.The usage of patiented controlled intravenous analgesia pump and recovery after surgery were compared between the two groups.Results: Compared with group Q,the remifentanil and propofol consumption intraoperatively were decreased(P<0.05).Compared with group Q,the plasma levels of IL-6 and TNF-α were lower,while IL-10 was higher at T1～T4 in group NQ(P<0.05).The VAS were lower at T1～T4 in group NQ than that in group Q(P<0.05),while Ramsay scale were no difference between the groups(P>0.05).Sufentanil consumption,the number of analgesic pump press and the number of patients requiring rescue analgesia within the first 24 h after surgery were lower,while time to first pressing PCIA was longer in group NQ than that of group Q(P<0.05).The time to recovery of intestinal function and mobilization time after surgery were earlier in group NQ than that in group Q.The presence of side effects was lower,as well as the satisfaction score of patients was higher in group NQ than that in group Q(P<0.05).Conclusions: Nalbuphine combined with ropivacaine in ultrasoundguided transmuscular quadratus lumborum block can reduce systemic inflammatory responses and provide more perfect postoperative analgesia in patients undergoing retroperitoneal laparoscopic nephrectomy.