Comparison Of Two Ultrasound-Guided Approaches Of Quadratus Lumbosum Block In Laparoscopic Colorectal Surgery

Objective:To compare the efficacy of ultrasound-guided anterior quadratus lumbar block(QLB)at the lateral supra-arcuate ligament and anterior quadratus Lumborum block in perioperative laparoscopic colorectal surgery.Methods:A total of 60 patients undergoing laparoscopic colorectal surgery under general anesthesia were divided into three groups using the random number table method.Group A was treated with general anesthesia combined with the ultrasound-guided anterior QLB at the lateral supra-arcuate ligament(n=20 cases).Group B was treated with general anesthesia combined with anterior QL block(n=20 cases).Group C was treated with general anesthesia.Group A received bilateral ultrasound guided anterior QLB at the lateral supra-arcuate ligament before general anesthesia induction,and each side was given 0.3% ropivacaine 30ml;Group B received bilateral anterior QLB before general anesthesia induction,and each side was given 0.3% ropivacaine 30ml;Group C received simple general anesthesia.Both groups were given PCIA after surgery.Compare the MAP and HR changes 5minutes before and after surgery start.Record the intraoperative consumption of sufentanil,the postoperative VAS score at0 h,4h,8h,12 h,24h and 48 h,the number of effective postoperative PCIA compressions,the number of remedial analgesia,the time of first out-of-bed activity and postoperative adverse reactions.Results:Compared with group C,MAP and HR fluctuated less in group A and Group B before and after skin resection(P<0.05),intraoperative sufentanil dosage was significantly reduced(P<0.05),and postoperative nausea and vomiting incidence was significantly reduced(P<0.05),with statistically significant differences.VAS scores in group A was significantly lower than that in group C within 48 h after surgery(P<0.05).The VAS scores in group B was lower than those in group C within 24 h after surgery(P<0.05),and there was no significant difference in 48 h VAS scores between group B and group C(P>0.05);There was no statistically significant difference in VAS scores within 24 hours after surgery between group A and Group B(P>0.05),but postoperative 48 h VAS scores in group A were lower than those in group B(P<0.05).Compared with Group A and B,the consumption of sufentanil in Group C increased significantly(P<0.05),and the incidence of postoperative nausea and vomiting increased significantly(P<0.05).Compared with group B,the incidence of postoperative weakness of lower limbs in group A and Group C was lower(P<0.05).Conclusion:This study shows that the ultrasound-guided anterior QLB at the lateral supra-arcuate ligament can provide perioperative analgesia similar to anterior QLB for laparoscopic colorectal surgery.However,the postoperative Analgesia time of anterior QLB at the lateral supra-arcuate ligament was longer than that of anterior QLB,and the occurrence of postoperative complications could be effectively reduced.