Analgesic effect of ultrasound-guided quadratus lumborum block combined with patient-controlled intravenous analgesia after lower abdominal surgery

LI Shu-ting; WU Tan-guang; YIN Guo-jiang; LI Kun; SONG Xiao-yang

doi:10.11659/jjssx.11E024058

您当前的位置：

首页 >

文章列表页 >

Analgesic effect of ultrasound-guided quadratus lumborum block combined with patient-controlled intravenous analgesia after lower abdominal surgery

Clinical Research | 更新时间：2025-10-24

- Analgesic effect of ultrasound-guided quadratus lumborum block combined with patient-controlled intravenous analgesia after lower abdominal surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 10, Pages: 904-907(2025)
- 作者机构：
  
  中部战区总医院麻醉科，湖北武汉 430014
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.11E024058
  CLC： R441.1
- Received：13 November 2024，
  
  Published：25 October 2025
- 稿件说明：
移动端阅览
李书庭,吴坛光,殷国江等.超声引导腰方肌阻滞联合静脉自控镇痛对下腹部手术后的镇痛作用[J].局解手术学杂志,2025,34(10):904-907.

LI Shu-ting,WU Tan-guang,YIN Guo-jiang,et al.Analgesic effect of ultrasound-guided quadratus lumborum block combined with patient-controlled intravenous analgesia after lower abdominal surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(10):904-907.
李书庭,吴坛光,殷国江等.超声引导腰方肌阻滞联合静脉自控镇痛对下腹部手术后的镇痛作用[J].局解手术学杂志,2025,34(10):904-907. DOI： 10.11659/jjssx.11E024058.

LI Shu-ting,WU Tan-guang,YIN Guo-jiang,et al.Analgesic effect of ultrasound-guided quadratus lumborum block combined with patient-controlled intravenous analgesia after lower abdominal surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(10):904-907. DOI： 10.11659/jjssx.11E024058.

摘要

目的

探讨超声引导腰方肌阻滞联合静脉自控镇痛在下腹部手术后的镇痛效果。

方法

前瞻性选取2021年4月至2024年4月在中部战区总医院进行下腹部手术的患者134例，随机分成观察组和对照组，每组67例。观察组患者进行超声引导腰方肌阻滞联合静脉自控镇痛。对照组患者仅进行静脉自控镇痛。比较2组患者术后4 h、6 h、12 h和24 h镇痛泵按压次数及舒芬太尼总用量，静息和运动状态下疼痛视觉模拟量表（VAS）评分，以及术后镇痛过程中不良反应发生率。

结果

与对照组相比，观察组患者术后6 h、12 h、24 h镇痛泵按压次数和舒芬太尼总用量均较少（

0.05）。观察组患者术后4 h、6 h、12 h、24 h运动VAS评分均显著低于对照组（

0.05）。观察组患者恶心、呕吐、眩晕的发生率显著低于对照组（

0.05）。

结论

与单纯静脉自控镇痛相比，超声引导腰方肌阻滞联合静脉自控镇痛在下腹部手术后镇痛中能明显减少镇痛泵按压次数和舒芬太尼总用量，且缓解运动疼痛效果更佳，并可减少恶心、呕吐等不良反应的发生。

Abstract

Objective

To investigate the analgesic effect of ultrasound-guided quadratus lumborum block combined with patient-controlled intravenous analgesia after lower abdominal surgery.

Methods

A total of 134 patients who underwent lower abdominal surgery in General Hospital of Central Theater Command from April 2021 to April 2024 were prospectively selected and randomly divided into the observation group and the control group，with 67 patients in each group.Patients in the observation group received ultrasound-guided quadratus lumborum block combined with patient-controlled intravenous analgesia. Patients in the control group underwent only patient-controlled intravenous analgesia. The number of analgesic pump compressions and the cumulative sufentanil consumption 4 hours，6 hours，12 hours，and 24 hours after surgery，the visual analogue score （VAS） of pain at rest and exercise，and the incidence of adverse reactions during postoperative analgesia were compared between the two groups.

Results

Compared with the control group，the number of analgesic pump compressions and the cumulative sufentanil consumption of patients were fewer/less at 6 hours，12 hours and 24 hours after surgery in the observation group （

0.05）. The VAS scores of patients at exercise 4 hours，6 hours，12 hours and 24 hours after surgery in the observation group were significantly lower than those in the control group （

0.05）.The incidence of nausea，vomiting and vertigo in the observation group was significantly lower than that in the control group （

0.05）.

Conclusion

Compared with patient-controlled intravenous analgesia，ultrasound-guided quadratus lumborum block combined with patient-controlled intravenous analgesia can significantly reduce the number of analgesia pump compressions and the cumulative sufentanil consumption in postoperative analgesia of lower abdominal surgery，and has a better effect in relieving exercise pain，it can also reduce the occurrence of adverse reactions such as nausea and vomiting.

关键词

Keywords

references

Xu W ， Zheng Y ， Wang Q ， et al . Impact of the addition of dexmedetomidine to patient-controlled intravenous analgesia on postoperative pain-sleep interaction cycle and delirium： a systematic review and meta-analysis of randomized controlled trials ［J］. Heliyon ， 2024 ， 10 （ 6 ）： e27623 . doi ： 10.1016/j.heliyon.2024.e27623 http://dx.doi.org/10.1016/j.heliyon.2024.e27623 .

雷宇，王茜，刘涛涛，等 . 超声引导下低位前锯肌平面和腹直肌鞘阻滞对肝叶切除术后疼痛、应激及早期康复的影响［J］. 西南医科大学学报， 2024 ， 47 （ 5 ）： 410 - 414 . doi： 10.3969/j.issn.2096-3351.2024.05.008 http://dx.doi.org/10.3969/j.issn.2096-3351.2024.05.008 .

罗洞波，史俊杰，维拉，等 . 氢吗啡酮自控镇痛静脉泵在肺癌病人中应用1例［J］. 中国疼痛医学杂志， 2022 ， 28 （ 10 ）： 798 - 800 . doi： 10.3969/j.issn.1006-9852.2022.10.015 http://dx.doi.org/10.3969/j.issn.1006-9852.2022.10.015 .

曾媛，王国华，杨勇 . 氢吗啡酮、舒芬太尼及吗啡在难治性癌痛合并口服困难患者静脉自控镇痛中的疗效比较研究［J］. 中国全科医学， 2022 ， 25 （ 36 ）： 4537 - 4545 . doi： 10.12114/j.issn.1007-9572.2022.0430 http://dx.doi.org/10.12114/j.issn.1007-9572.2022.0430 .

姚富，税云华，向继林，等 . 腹股沟韧带上髂筋膜阻滞联合经静脉患者自控镇痛在老年髋关节置换术后的应用［J］. 中国骨伤， 2024 ， 37 （ 5 ）： 482 - 487 . doi： 10.12200/j.issn.1003-0034.2022 http://dx.doi.org/10.12200/j.issn.1003-0034.2022 .

王东 . 基于视觉模拟评分法和免疫功能指标评估全身麻醉复合腰方肌阻滞在老年妇科肿瘤患者围术期的应用价值［J］. 中国医刊， 2023 ， 58 （ 4 ）： 417 - 421 . doi： 10.3969/j.issn.1008-1070.2023. 04.019 http://dx.doi.org/10.3969/j.issn.1008-1070.2023.04.019 .

廖春英，王云，李慧利，等 . 超声引导下外侧弓状韧带上腰方肌前路阻滞与腹横肌平面阻滞在子宫切除术中的比较［J］. 临床麻醉学杂志， 2022 ， 38 （ 7 ）： 716 - 720 . doi： 10.12089/jca.2022.07.009 http://dx.doi.org/10.12089/jca.2022.07.009 .

许敏，杨静 . 腰方肌阻滞在腹部手术后镇痛的应用进展［J］. 中国微创外科杂志， 2020 ， 20 （ 5 ）： 459 - 462 . doi： 10.3969/j.issn.1009-6604.2020.05.019 http://dx.doi.org/10.3969/j.issn.1009-6604.2020.05.019 .

Hirai S ， Ida M ， Naito Y ， et al . Comparison between the effects of epidural and intravenous patient-controlled analgesia on postoperative disability-free survival in patients undergoing thoracic and abdominal surgery： A post hoc analysis ［J］. Eur J Pain ， 2024 ， 28 （ 8 ）： 1356 - 1365 . doi： 10.1002/ejp.2266 http://dx.doi.org/10.1002/ejp.2266 .

Chen M ， Zhang B . Letter to the editor regarding "effect of ropivacaine intercostal nerve block combined with patient controlled intravenous analgesia on postoperative analgesia after breast augmentation" ［J］. Aesthetic Plast Surg ， 2024 ， 48 （ 20 ）： 4142 - 4143 . doi： 10.1007/s00266-024-04081-3 http://dx.doi.org/10.1007/s00266-024-04081-3 .

李晓勤，王群，何晓兰，等 . 多模式镇痛对原发性肝癌患者休斯顿疼痛情况调查表评分及血清结合珠蛋白水平的影响［J］. 陕西医学杂志， 2024 ， 53 （ 4 ）： 475 - 478 . doi： 10.3969/j.issn.1000-7377. 2024.04.008 http://dx.doi.org/10.3969/j.issn.1000-7377.2024.04.008 .

吴觉伦，田园，聂卫华，等 . 手术患者接受患者自控静脉镇痛期间发生术后恶心呕吐的危险因素分析［J］. 协和医学杂志， 2024 ， 15 （ 2 ）： 366 - 374 . doi： 10.12290/xhyxzz.2023-0579 http://dx.doi.org/10.12290/xhyxzz.2023-0579 .

王玉秀，沈露露，胡丹丹 . 超声引导下腰方肌阻滞用于腹腔镜结直肠手术围手术期的麻醉效果及对术后睡眠质量的影响［J］. 中国现代医学杂志， 2023 ， 33 （ 24 ）： 94 - 100 . doi： 10.3969/j.issn.1005-8982.2023.24.016 http://dx.doi.org/10.3969/j.issn.1005-8982.2023.24.016 .

张莉莉，杨雅婷，贾倩倩 . 超声引导菱形肌-肋间肌阻滞和TPVB在电视胸腔镜手术术后早期疼痛控制中的应用比较［J］. 临床和实验医学杂志， 2024 ， 23 （ 8 ）： 894 - 897 . doi： 10.3969/j.issn.1671-4695.2024.08.030 http://dx.doi.org/10.3969/j.issn.1671-4695.2024.08.030 .

杨泽群，丁玉美，柴国东，等 . 纳布啡、舒芬太尼联合氟比洛芬酯在腹腔镜子宫切除术后自控静脉镇痛中对疼痛介质释放的影响［J］. 中国现代医学杂志， 2023 ， 33 （ 20 ）： 31 - 37 . doi： 10.3969/j.issn. 1005-8982.2023.20.006 http://dx.doi.org/10.3969/j.issn.1005-8982.2023.20.006 .

孙晓佳，汪业铭，孟晨雪，等 . 超声引导腰方肌阻滞联合少阿片全身麻醉方案在老年腹腔镜肾癌根治术中的应用［J］. 中国老年学杂志， 2023 ， 43 （ 18 ）： 4398 - 4400 . doi： 10.3969/j.issn.1005-9202. 2023.18.015 http://dx.doi.org/10.3969/j.issn.1005-9202.2023.18.015 .

范倩倩，计根林，聂煌，等 . 小剂量氢吗啡酮复合纳布啡用于胃肠道手术后患者自控静脉镇痛的效果［J］. 临床麻醉学杂志， 2023 ， 39 （ 7 ）： 719 - 724 . doi： 10.12089/jca.2023.07.009 http://dx.doi.org/10.12089/jca.2023.07.009 .

李响，贾梦醒，高震南，等 . 两种不同入路腰方肌阻滞在腹腔镜直肠癌根治术中的应用［J］. 实用医学杂志， 2023 ， 39 （ 10 ）： 1258 - 1262 . doi： 10.3969/j.issn.1006-5725.2023.10.012 http://dx.doi.org/10.3969/j.issn.1006-5725.2023.10.012 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

No data

Related Author

No data

Related Institution

No data

⁰