Application of ultrasound-guided quadrat block in postoperative analgesia of inguinal hernia in children

doi:10.3877/cma.j.issn.1674-392X.2023.01.018

Abstract

Abstract:

Objective

To investigate the use of ultrasound-guided quadratus lumborum block (QLB) in pediatric patients undergoing laparoscopic inguinal hernia surgery.

Methods

A total of 84 children who were treated for inguinal hernias in our hospital from July 2021 to February 2022 were selected as the research subjects. The number random table method was used to randomly divide 70 children into a control group (n=35) and a trial. Group (n=35). All of the children received traditional general anesthesia induction. The children in the test group were given QLB (0.25% ropivacaine, 0.5 ml/kg) on the basis of ultrasound guidance, and the children in the control group were given normal saline (sevoflurane was given during the operation). Record the general conditions of the two groups of children, postoperative related indicators, Cravero score and the incidence of restlessness, observe the postoperative pain, heart rate and mean arterial pressure of the two groups of children at different times, and the application of salvage analgesics condition.

Results

There was no significant difference in gender, age, weight, and height between the two groups (P>0.05). After the operation, the hospitalization time of the children in the experimental group was significantly shorter than that in the control group (P<0.05). After the operation, the Cravero score and the incidence of restlessness in the experimental group were significantly lower than those in the control group (P<0.05). The FLACC scores of the experimental group were significantly lower than those of the control group at 2, 4, 12, and 24 h after operation (P<0.05). The MAP and heart rate of the experimental group were significantly lower than those of the control group at 1, 3, 6, 12, and 24 h after the operation (P<0.05), and the fluctuation of MAP and heart rate in each period was small. The total number of 24 h salvage analgesia cases in the experimental group was 2 cases, which accounted for 5.71% of the total number. 28.57% of 10 cases in the control group (P<0.05).

Conclusion

Ultrasound-guided QLB has a definite clinical effect in pediatric laparoscopic inguinal hernia surgery. It can effectively relieve postoperative restlessness in children, reduce the application of postoperative salvage analgesics, reduce postoperative pain, and shorten the hospitalization time for children.

Key words: Ultrasound, Quadratus lumborum block, Child, Hernia, inguinal, Laparoscopy, Herniorrhaphy

Yuanhao Qin, Yujie Liang, Linghui Wei, Zhijian You. Application of ultrasound-guided quadrat block in postoperative analgesia of inguinal hernia in children[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(01): 74-78.

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Figures/Tables 6

References 23

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组别	例数	性别[例(%)]		年龄(岁,±s)	体重(kg,±s)	身高(cm,±s)	疝部位[例(%)]		疝类型[例(%)]
组别	例数	男	女	年龄(岁,±s)	体重(kg,±s)	身高(cm,±s)	左侧	右侧	直疝	斜疝
试验组	35	29(82.9)	6(17.1)	4.14±1.31	17.35±3.89	95.43±14.24	21(60.0)	14(40.0)	7(20.0)	28(80.0)
对照组	35	27(77.1)	8(22.9)	4.23±1.40	17.87±4.01	94.57±13.89	19(54.3)	16(45.7)	8(22.9)	27(77.1)
t/χ²值		0.357		0.278	0.551	0.256	0.233		0.085
P值		0.550		0.782	0.584	0.7799	0.629		0.771

组别	例数	性别[例(%)]		年龄(岁,±s)	体重(kg,±s)	身高(cm,±s)	疝部位[例(%)]		疝类型[例(%)]
组别	例数	男	女	年龄(岁,±s)	体重(kg,±s)	身高(cm,±s)	左侧	右侧	直疝	斜疝
试验组	35	29(82.9)	6(17.1)	4.14±1.31	17.35±3.89	95.43±14.24	21(60.0)	14(40.0)	7(20.0)	28(80.0)
对照组	35	27(77.1)	8(22.9)	4.23±1.40	17.87±4.01	94.57±13.89	19(54.3)	16(45.7)	8(22.9)	27(77.1)
t/χ²值		0.357		0.278	0.551	0.256	0.233		0.085
P值		0.550		0.782	0.584	0.7799	0.629		0.771

组别	例数	手术时间(min)	麻醉时间(min)	苏醒时间(min)	住院时间(d)
试验组	35	28.64±5.24	40.52±8.42	10.34±3.17	4.31±1.24
对照组	35	29.76±4.97	42.34±7.91	9.88±2.89	4.93±1.30
t值		0.917	0.932	0.634	2.042
P值		0.362	0.355	0.528	0.045

组别	例数	手术时间(min)	麻醉时间(min)	苏醒时间(min)	住院时间(d)
试验组	35	28.64±5.24	40.52±8.42	10.34±3.17	4.31±1.24
对照组	35	29.76±4.97	42.34±7.91	9.88±2.89	4.93±1.30
t值		0.917	0.932	0.634	2.042
P值		0.362	0.355	0.528	0.045

组别	例数	Cravero评分(分,±s)	躁动发生率[例(%)]
试验组	35	2.20±0.53	2(5.71)
对照组	35	3.43±0.47	8(22.86)
t值		10.272	4.200
P值		0.000	0.040

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