Application Of Quaratus Lumborum Block Versus Transversus Abdominis Plane Block On Enhanced Recovery After Laparoscopic Radical Resection Of Colorectal Cancer

Objective:To compare the effect of quadratus lumborum block(QLB)and transversus abdominis plane block(TAPB)on postoperative rehabilitation of patients undergoing laparoscopic radical resection of colorectal cancer.Methods:Eighty patients underwent elective laparoscopic radical resection of colorectal cancer,with a body mass index(BMI)of 18-32 kg/m~2,aged 18-70 years,ASA I or II.The random number table method was randomly divided into two groups,40 in each group,which were QLB group and TAP group.The QLB group and the TAP group underwent bilateral ultrasound-guided QLB and TABP before induction of anesthesia,and each side was given 0.375%ropivacaine 20 ml.All patients were treated with sufentanil for patient-controlled intravenous analgesia(PCIA).Changes in blood pressure and heart rate were recorded immediately and 5 min after incision,and the differences?SBP,?DBP,and?HR were calculated.The dose of remifentanil was recorded during the operation;the resting and coughing visual analogue scale(VAS)was recorded at 2 h,4 h,6 h,24 h,and 48 h after surgery;the postoperative 0~12 h,12~24 h,24~48 h sufentanil consumption was recorded;record the initial compression time of analgesia pump,anal exhaust time,first time to get out of bed,postoperative analgesia satisfaction score,the incidence of postoperative adverse reactions such as nausea,vomiting,dizziness,and itching of the skin.Results::?SBP,?DBP and?HR in the QLB group were significantly smaller than those in the TAP group(P<0.05).The dose of remifentanil in the QLB group and the consumption of sufentanil at 0-12 h and 12-24 h after surgery were significantly lower than those in the TAP group(P<0.05).The first compression time of the analgesic pump in the QLB group was significantly later than that in the TAP group(P<0.05).The anus exhaust time and the first time to get out of bed in the QLB group were significantly earlier than those in the TAP group(P<0.05).The incidence of nausea,vomiting and dizziness in the QLB group was significantly lower than those in the TAP group(P<0.05).The postoperative analgesia satisfaction of the QLB group was significantly better than that of the TAP group(P<0.05).There was no significant difference in the consumption of sufentanil at 24~48 h,and resting and coughing VAS scores at 2 h,4 h,6 h,24 h,48 h after surgery(P>0.05).Conclusion:Quadratus lumborum block is more effective than transversus abdominis plane block to reduce the perioperative opioid dosage and the incidence of postoperative nausea and vomiting and dizziness in patients undergoing laparoscopic radical colorectal cancer.Moreover,the patient's time of getting out of bed and the time of anal exhaust were significantly advanced,and the postoperative analgesic effect was satisfactory,which was more conducive to postoperative rehabilitation.