A Retrospective Study About Effect Of Quadratus Lumborum Block On Recovery Quality In Patients With Laparoscopic Gastrointestinal Tumor Resection

Objective:To retrospectively analyze the effect of ultrasound-guided quadratus lumborum block(QLB)on recovery quality in patients with laparoscopic gastrointestinal tumor resection and estimate the correlation between QLB and postoperative recovery quality,which maybe provide advice for the improvement of the quality of anesthesia recovery.Method:This is an observational and retrospective clinical study in a single center.A total of 280 patients undergoing surgery of laparoscopic gastrointestinal tumor were collected from the Second Affiliated Hospital of Nanchang University Medical College from July 1,2017 to March 10,2018.The selected patients were numbered one by one and recorded demographic characteristics and ntraoperative information.According to whether or not received QLB before surgery,the patients were divided into two groups.They were respectively QLB group(only bilateral QLB)and not QLB group(including failure of QLB).Patients who received QLB were defined as intervention group(group Y).By matching the group Y 1:1 to patients who not received QLB with most comparable propensity scores,the reference group(group N)was identified and then collected two groups? clinical outcomes related to recovery quality.We planned to study the following postoperative outcomes: tracheal extubation within 30 min,visual analogue scale(VAS)7-10 points,sedation agitation score(SAS)?/?,bruggrmann comfort score(BCS)0-1 point,delayed recovery and Steward ? 4 points within 1 h.Further,we analysis the correlation of preoperative quadratus lumborum muscle block and recovery-related outcomes.Result:According to 1:1 propensity score matching,the group Y comprised 63 patients and the group N 63.Compare to group N,Patients in group Y experienced shorter tracheal extubation time 50.8% vs 31.7(OR,0.45;95% CI,0.17–1.52;P=0.025),lower VAS 28.6% vs 12.7%(OR,0.36;95% CI 0.27–1.94;P=0.017);higher BCS 17.5% vs 7.9%(OR,0.61;95% CI 0.30–2.87;P=0.043)and lower SAS 11.1% vs 6.3%(OR,0.38;95% CI 0.36–1.12;P=0.046).There were no significant differences in observation time in PACU and delayed recovery between the two groups(OR,0.87;95% CI,0.52–2.71;P=0.887;OR,1.03;95% CI,0.50–4.63;P=0.902).Conclusion:In this retrospective analysis,preoperative ultrasound-guided QLB can shorten tracheal extubation time and improve recovery quality in patients undergoing laparoscopic gastrointestinal tumor resection.However,preoperative QLB were not associated with PACU off and delayed recovery.