Preoperative Ultrasound-guided Quadratus Lumborum Block On The Early Postoperative Outcome In Patients Undergoing Radical Gastrectomy For Gastric Cancer

Objective:To evaluated the analgesic effects of preoperative ultrasound-guided quadratus lumborum block in patients undergoing radical gastrectomy for gastric cancer.Methods:Sixty patients withgastric cancer.were randomly divided into two group,30 cases in each.Before the operation,the patients in group QLB underwent ultrasound guided bilateral QLB before surgury,20 ml of 0.375% ropivacaine was given to these patients in each injection.Patients in group C received equal amount of physiological saline.Two groups of patients were given intravenous self-control analgesia at the end of operation(PCIA).The values of mean blood pressure(MBP),heart rate(HR)immediately before and 5 minutes after cutting were oberserved and recorded.Record the patients,Sufentanil dosage,the pain scores were assessed with VAS at2 h,6h,12 h,24h,48 h at postoperatively rest and activit.The first time pressing the analgesic pump button,The effective press times of PCA in 24 h and 48 h after operation,the remedial rate of extra analgesic drugs,times of remedial analgesia,the first time anus exhaust,the time getting out of bed and the during of hospital.The patient's satisfaction with postoperative analgesia and Postoperative adverse reaction were recorded in the two groups.Results:The changes of MBP and HR 5 min before and after skin incision in group Q group were significantly lower than those in group C(P <0.05).The usage of sufentanil in group Q significantly decreased compared with that in group C(P <0.05).Compared with C group,the VAS scores at rest and activit in 2h,6h,12 h,24h postoperatively appeared significantly lower(P<0.05).The VAS scores at rest and activit in 48 h postoperatively were not significantly different between the two groups(P>0.05).The first time pressing the analgesic pump button in group Q wassignificantly later than that in group C(P <0.05).The effective press times of analgesic pump significantly decreased in Q group at 24 h and 48 h hours after operation compared with that in group C(P <0.05).The times of remedial analgesia in group Q were lower than that in group C(P <0.05).Further the first time off-bed,he first time anus exhaus and the during of hospital in group T were shorter than group C(P <0.05).The patient's satisfaction with postoperative analgesia was significantly higher in group Q compared with that in group C(P <0.05).The incidence of nausea,vomiting and vertigo was significantly reduced in group Q(P <0.05).Conclusion:Preoperative ultrasound-guided analgesia with quadratus quadratus block can significantly reduce the dosage of opioids in patients undergoing radical gastrectomy.Postoperative analgesia is satisfactory,with few adverse reactions,which improves patient comfort and is more conducive to early recovery of patients.