Clinical observation of the quadratus lumborum and fascia trans versalis block guided by ultrasound combined with PCIA in the analgesia of lower abdominal surgery in the elderly

Objective To observe the analgesic effects of the quadratus lumborum block(QLB) and transversus abdomins plane guided by ultrasound combined with PCIA in the elderly after lower abdominal surgery.

Methods Ninety elderly patients scheduled by endoscopic radical resection of rectal cancer under general anesthesia were randomly divided into the quadratus lumbosus block group(QLB group, 30 cases), fascia trans versalis block group(TAP group, 30 cases) and simple general anesthesia group(S group, 30 cases) using the random number table method.The various indexes in three groups were observed.The total amount of sufentanil, and VAS scores of rest and exercise after 4, 8, 12, 24 and 48 hours in three groups were recorded, and the postoperative adverse reaction and analgesic satisfaction of patients were evaluated.

Results The total amount of sufentanil in QLB group and TAP group at each postoperative time-point were less than that in S group(P < 0.01), and the VAS scores of rest and exercise in QLB group and TAP group at each postoperative time-point were less than that in S group(P < 0.01).The total amount of sufentanil in QLB group at each postoperative time-point was less than that in TAP group(P < 0.01), and the VAS score of rest in QLB group at each postoperative time-point was less than that in TAP group(P < 0.01).The difference of the VAS score of exercise between QLB group and TAP group at postoperative 4 h was not statistically significant(P>0.05).The postoperative analgesic satisfaction in QLB group was higher than that in TAP group and S group(P < 0.01).

Conclusions The quadratus lumborum block guided by ultrasound can achieve satisfactory analgesic effect and reduce the use of opioids during and after surgery, and the analgesic satisfaction of which is better than that of fascia trans versalis block.