Effect Of Quadratus Lumborum Block With Different Concentrations Of Ropivacaine On Children’s Laparoscopic Operation Analgesia

Objective:To investigate the effectiveness and safety of quadratus lumborum block with different concentrations of ropivacaine for perioperative analgesia in children undergoing laparoscopic high position ligation of hernia sac and processus vaginalis.Methods:72 children with laparoscopic herniorrhaphy or sheath process ligation were selected,aged 3-6 years,weighing 13-24 kg,ASA physical statusⅠ or II,were randomly divided into three groups(n=24 each):0.15% ropivacaine group(group C15),0.20% ropivacaine group(group C20),0.25% ropivacaine group(group C25).Ultrasound-guided bilateral quadratus lumborum block was performed after general anesthesia and prior to surgery,and 0.15%,0.20%,0.25% ropivacaine 0.4ml/kg were bilaterally injected into three groups.Record the time of first use of remedial analgesic drugs,the number of children needing remedial analgesia and the amount of remedial analgesic drugs within the first 12 h.The FLACC scores and the FACES scores were evaluated at 1h,2h,4h,6h,8h,10 h and 12 h after surgery.Incidence of anesthesia emergence deliri and quadratus lumborum block complications such as puncture site hematoma,infection,peripheral organ injury,local anesthetic toxicity,lower limb muscle strength decrease and hypotension were recorded.Results:The first time of analgesia was significantly longer in the C25 group than in the C15 group(P<0.05),the number of children in need of analgesia and the total amount of analgesic drugs needed were significantly less than in the C15 group(P<0.05).The 1h,2h and 4 h FLACC scores and FACES scores of C25 groups were significantly lower than those of C15 group(P<0.05).The 1h and 4h FLACC scores of C25 group was significantly lower than that of C20 group(P<0.05).The 1h,2h and 4 h FACES scores of C25 group was significantly lower than that of C20 group(P<0.05).The highest FLACC and FACES scores of C20 group and C25 group were significantly lower than those of C15 group.There was no significant difference in the incidence of anesthesia emergence deliri in all three groups.There were no side effects in all children.Conclusion : 0.25% ropivacaine 0.4 ml/kg of ultrasound-guided bilateral quadratus lumborum block can delay the first time of remedial analgesia within the first 12 h and improve the analgesic effect after laparoscopic high position ligation of hernia sac and processus vaginalis.It is worthy of promotion and application in clinical practice.