|Table of Contents|

The effect of ultrasound-guided modified anterior quadrate block on postoperative analgesia in gynecological tumor patients

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2025 03
Page:
453-458
Research Field:
Publishing date:

Info

Title:
The effect of ultrasound-guided modified anterior quadrate block on postoperative analgesia in gynecological tumor patients
Author(s):
FU Guohui1; GUANG Wenhui2; ZHANG Lingmin3; PENG Chunchao2; REN Rong1; HE Zongzhao2
1.Graduate School of Qinghai University,Qinghai Xining 810016,China;2.Department of Anesthesiology,Qinghai Provincial People's Hospital,Qinghai Xining 810007,China;3.Department of Anesthesiology,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China.
Keywords:
gynecological tumor surgery; modification anterior quadrata block; postoperative pain; VAS score
PACS:
R737.3
DOI:
10.3969/j.issn.1672-4992.2025.03.015
Abstract:
Objective:To evaluate the analgesic effect of ultrasound-guided modified anterior quadrate block in gynecological tumor surgery.Methods:A total of 94 patients undergoing elective endoscopic surgery for gynecologic tumors were randomly divided into two groups:Group Q (modified anterior quadrate block group,n=47) and group C (group without quadrate block group,n=47).Before anesthesia induction,group Q was given 0.33% ropivacaine 20 mL on each side of bilateral improved anterior quadrate block under ultrasound guidance.After the operation,both groups underwent controlled intravenous analgesia (PCIA).The main outcome measures were recorded:Resting and exercise VAS scores at 2 h,6 h,24 h and 48 h after surgery.Relief of analgesia within 48 h after surgery.Secondary indexes:Perioperative propofol and opioid dosage.2 h,6 h,24 h,48 h BCS score after surgery.Postoperative first time of getting out of bed,anal exhaust time,eating time,postoperative hospitalization time,postoperative skin itching,nausea and vomiting and other adverse reactions.Results:The demand for analgesics in 48 h Q group was lower than that in C group (P＜0.05).The VAS scores at rest and exercise in Q group at 2 h,6 h and 24 h after operation were lower than those of C group (P＜0.05).There was no significant difference in VAS scores at rest and exercise at 48 h.BCS scores at 2 h,6 h,24 h and 48 h were higher than those in C group (P＜0.05).Perioperative opioid consumption in group Q was significantly lower than that in group C (P＜0.05).There was no significant difference in the dosage of propofol between the two groups.The time of getting out of bed for the first time,anal exhaust time and feeding time in group Q were significantly shorter than those in group C (P＜0.05).There was no significant difference in length of stay between the two groups.The incidence of postoperative nausea,vomiting and pruritus in group Q was significantly lower than that in group C (P＜0.05).Conclusion:Ultrasound-guided modified anterior quadrate block can reduce postoperative analgesic drug demand,reduce pain score,promote postoperative recovery and reduce opioid adverse reactions in patients undergoing gynecological tumor surgery.

References:

［1］ WANG X,LIU W,XU Z,et al.Effect of dexmedetomidine alone for intravenous patient-controlled analgesia after gynecological laparoscopic surgery:a consort-prospective,randomized,controlled trial［J］.Medicine (Baltimore),2016,95(19):e3639.
[2] SOUSA AM,ROSADO GM,NETO JS,et al.Magnesium sulfate improves postoperative analgesia in laparoscopic gynecologic surgeries:a double-blind randomized controlled trial［J］.J Clin Anesth,2016,34:379-384.
[3] HUANG L,ZHENG L,ZHANG J,et al.Transmuscular quadratus lumborum block versus oblique subcostal transversus abdominis plane block for analgesia in laparoscopic hysterectomy:a randomised single-blind trial［J］.BMJ Open,2021,11(8):e43883.
[4] LI HJ,LIU S,GENG ZY,et al.Adding dexmedetomidine to morphine-based analgesia reduces early postoperative nausea in patients undergoing gynecological laparoscopic surgery:a randomized controlled trial［J］.BMC Anesthesiol,2020,20(1):11.
[5] WILSON SH,GEORGE RM,MATOS JR,et al.Preoperative quadratus lumborum block reduces opioid requirements in the immediate postoperative period following hip arthroscopy:a randomized,blinded clinical trial［J］.Arthroscopy,2022,38(3):808-815.
[6] AHMED A,FAWZY M,NASR M,et al.Ultrasound-guided quadratus lumborum block for postoperative pain control in patients undergoing unilateral inguinal hernia repair,a comparative study between two approaches［J］.BMC Anesthesiol,2019,19(1):184.
[7] ELSHARKAWY H,AHUJA S,DEGRANDE S,et al.Subcostal approach to anterior quadratus lumborum block for pain control following open urological procedures［J］.J Anesth,2019,33(1):148-154.
[8] ZHU M,MEI Y,ZHOU R,et al.Effects of anterior approach to quadratus lumborum block on postoperative cognitive function following hip surgery in older people:a randomized controlled clinical trial［J］.BMC Geriatr,2023,23(1):835.
[9] KWAK KH,BAEK SI,KIM JK,et al.Analgesic effect of ultrasound-guided preoperative unilateral lateral quadratus lumborum block for laparoscopic nephrectomy:a randomized,double-blinded,controlled trial［J］.J Pain Res,2020,13:1647-1654.
[10] ALVES BV,SILVA GN,ALVIM FR,et al.Outcome of ultrasound guided anterior quadratus lumborum block after video laparoscopic cholecystectomies:a prospective randomized clinical trial［J］.Surg Innov,2023,30(3):283-296.
[11] 尹昕睿,韩侨宇,栗亚茹,等.腰方肌阻滞在髋关节术后镇痛中的应用［J］.临床麻醉学杂志,2024,40(06):644-647. YIN XR,HAN QY,LI YR,et al.Application of quadrate block in hip joint postoperative analgesia ［J］.Journal of Clinical Anesthesiology,2024,40(06):644-647.
[12] 温健,李欣,严军,等.腰方肌阻滞用于老年患者肾癌根治术的镇痛效果评价［J］.现代肿瘤医学，2020，28（8）：1362-1365. WEN J,LI X,YAN J,et al.The analgesia effect of quadratus lumborum block (QLB) in elderly patients undergoing laparoscopic radical nephrectomy［J］.Modern Oncology,2020，28（8）：1362-1365.
[13] ALVER S,BAHADIR C,TAHTA AC,et al.The efficacy of ultrasound-guided anterior quadratus lumborum block for pain management following lumbar spinal surgery:a randomized controlled trial［J］.BMC Anesthesiol,2022,22(1):394.
[14] 李运,孙义,张析哲,等.超声引导下肋下前路腰方肌阻滞对后腹腔镜肾脏手术后镇痛效果的影响［J］.临床麻醉学杂志,2020,36(08):745-749. LI Y,SUN Y,ZHANG XZ,et al.Effect of ultrasound-guided subcostal anterior quadrate block on analgesia after retrolaparoscopic kidney surgery ［J］.Journal of Clinical Anesthesiology,2020,36(08):745-749.
[15] 孟昭骞.不同容量罗哌卡因肋下前路腰方肌阻滞用于腹腔镜胆囊切除术的效果［D］.济南：山东大学,2023. MENG ZQ.Effect of subcostal anterior block of ropivacaine with different volume on laparoscopic cholecystectomy ［D］.Jinan:Shandong University,2023.
[16] BILGIN S,AYGUN H,GENC C,et al.Comparison of ultrasound-guided transversalis fascia plane block and anterior quadratus lumborum block in patients undergoing caesarean delivery:a randomized study［J］.BMC Anesthesiol,2023,23(1):246.
[17] 董凤良,杜方民,董小芳,等.阿片类药物导致便秘的机制及治疗［J］.医学综述,2014,20(02):288-291. DONG FL,DU FM,DONG XF,et al.Mechanism and treatment of constipation induced by opioids ［J］.Medical Review,2014,20(02):288-291.
[18] 闫玉栋.超声引导下前路腰方肌阻滞用于腹腔镜妇科手术的镇痛效果［J］.当代医学,2022,28(15):46-49. YAN YD.Analgesic effect of ultrasound-guided anterior quadrate block in laparoscopic gynecological surgery ［J］.Journal of Current Medicine,2022,28(15):46-49.

Memo

Memo:
2023年青海省“昆仑英才·高层次卫生健康人才”项目（青人才字〔2023〕9号，青人才字〔2023〕10号）
Last Update: 1900-01-01