探讨超声引导下前、后路腰方肌阻滞（QLB）在单侧腹股沟疝修补术后镇痛的效果。

选择2020年2月至2022年2月芜湖市第一人民医院择期行单侧开放性腹股沟疝修补术的患者60例，随机分为前路QLB组（A组）和后路QLB组（B组），每组30例。全身麻醉诱导前行QLB。术毕行舒芬太尼静脉自控镇痛，肌注地佐辛进行补救镇痛。记录术后2、6、12、24 h静息及从躺卧姿势坐立时数字疼痛评价量表（NRS）评分、镇痛泵首次按压时间、镇痛泵有效按压次数、24 h内补救性镇痛例数、口述评分法满意度评分；记录下肢肌力减退、恶心呕吐、嗜睡、低血压等不良反应及感染、内脏损伤、血肿、局部麻醉药中毒等并发症发生情况。

A组术后12、24 h从躺卧姿势坐立时NRS评分低于B组（P<0.05），A组术后48 h高满意度比例显著高于B组（P<0.05），A组镇痛泵首次按压时间、镇痛泵有效按压次数、24 h补救性镇痛例数、恶心呕吐发生率显著少于B组（P<0.05）；2组低血压、肌力减退、嗜睡发生率差异无统计学意义（P>0.05），2组均无感染、内脏损伤、血肿、局部麻醉药中毒等并发症发生。

对于行单侧腹股沟疝修补术的患者，超声引导下前路QLB的镇痛效果优于后路。

To investigate the effects of ultrasound-guided anterior and posterior quadratus lumborum block (QLB) for analgesia after unilateral inguinal hernia repair surgery.

Sixty patients who underwent elective unilateral open inguinal hernia repair in Wuhu First People's Hospital from February 2020 to February 2022 were selected and randomly divided into anterior QLB group (group A) and posterior QLB group (group B), with 30 patients in each group. QLB was performed before general anesthesia induction. Sufentanil PICA was completed after the operation. Intramuscular injection of dezocine was given for remedial analgesia. Numerical rating scale (NRS) scores were recorded at 2, 6, 12, 24 h postoperatively at rest and when sitting up from the lying position. The first pressing time of analgesia pump, analgesia pump effective press number, the number of cases requiring remedial analgesia within 24 h, and VRS satisfaction score were recorded. The occurrence of lower limb muscle weakness, nausea and vomiting, drowsiness, hypotension and other adverse reactions and complications such as infection, visceral injury, hematoma, and local anesthetic poisoning were recorded.

The NRS score when sitting up from the lying position of group A was lower than that of group B at 12 and 24 h after surgery (P<0.05). The proportion of high satisfaction in group A was significantly higher than that of group B (P<0.05) at 48 h after operation. The first pressing time of the analgesic pump, the number of effective pressing of the analgesic pump, the number of 24 h remedial analgesia cases, and the incidence of nausea and vomiting in group A were significantly lower than those in group B (P<0.05). There was no statistically significant difference in the incidence rates of hypotension, muscle weakness, and drowsiness between the two groups (P>0.05). There were no complications such as infection, visceral injury, hematoma, and local anesthetic poisoning in the two groups.

For patients undergoing unilateral inguinal hernia repair, the analgesic effect of anterior QLB under ultrasound guidance is better than that of posterior approach.