Efficacy of ultrasound-guided quadratus lumborum block for analgesia after laparoscopic cholecystectomy

Objective To evaluate the efficacy of ultrasound-guided quadratus lumborum block for analgesia after laparoscopic cholecystectomy. Methods Sixty American Society of Anesthesiologists physical statusⅠorⅡ patients, aged 18-64 yr, with body mass index of 20-27 kg/m2, scheduled for elective laparoscopic cholecystectomy, were divided into 2 groups (n=30 each) using a random number table method: ultrasound-guided transversus abdominis plane block group (group T) and ultrasound-guided quadratus lumborum block group (group Q). In T and Q groups, bilateral ultrasound-guided transversus abdominis plane block and quadratus lumborum block were performed after general anesthesia induction, respectively, with 0.25% ropivacaine 20 ml for each side.All the patients received patient-controlled intravenous analgesia with morphine after surgery, and visual analoge scale scores were maintained ≤3 in the two groups.The cumulative consumption of morphine was recorded at 2, 4, 6, 12, 24 and 48 h after surgery.The occurrence of adverse reactions such as nausea, vomiting, pruritus, over-sedation and respiratory depression was observed and recorded in the analgesic period.The operation time for nerve blocks and nerve blocks-related complications such as bleeding, accidental puncture into the abdominal cavity or intestinal injuries were recorded. Results Compared with group T, the cumulative consumption of morphine was significantly decreased at 6, 12, 24 and 48 h after surgery in group Q (P 0.05). There were no adverse reactions such as nausea, vomiting, pruritus, over-sedation and respiratory depression or nerve blocks-related complications in the two groups. Conclusion Ultrasound-guided quadratus lumborum block provides better efficacy than transversus abdominis plane block when used for analgesia after laparoscopic cholecystectomy. Key words: Nerve block; Analgesia; Ultrasonography; Laparoscopy