【摘要】 目的：比较超声引导下腰方肌阻滞与双侧腹横肌平面阻滞在妇科腹腔镜术后患者镇痛中的效果。方法：选取2022年4月至2023年4月86例于该院择期行妇科腹腔镜手术的患者进行前瞻性研究，按照随机数字表法将其分为观察组与对照组各43例。两组术后均采用常规静脉自控镇痛，在此基础上，对照组术后采用超声引导下双侧腹横肌平面阻滞，观察组术后采用超声引导下腰方肌阻滞。比较两组术后首次按压镇痛泵时间、首次下床活动时间、静脉自控镇痛舒芬太尼总用量、视觉模拟评分法（VAS）评分和不良反应发生率。结果：观察组首次按压镇痛泵时间长于对照组，首次下床活动时间短于对照组，静脉自控镇痛舒芬太尼总用量少于对照组，差异有统计学意义（P<0.05）；术后2、6、12 h，观察组静息和活动（咳嗽）状态下VAS评分均低于对照组，差异有统计学意义（P<0.05）；术后48 h，观察组不良反应发生率为6.98%，低于对照组的23.26%，差异有统计学意义（P<0.05）。结论：超声引导下腰方肌阻滞应用于妇科腹腔镜术后患者镇痛可缩短首次下床活动时间，延长首次按压镇痛泵时间，减少静脉自控镇痛舒芬太尼总用量，降低VAS评分和不良反应发生率，效果优于超声引导下双侧腹横肌平面阻滞。更多还原

【Abstract】 Objective: To compare analgesic effects of ultrasound-guided quadratus lumborum block and bilateral transversus abdominis plane block in patients after gynecological laparoscopic surgery. Methods: A prospective study was conducted on 86 patients undergoing elective gynecological laparoscopic surgery from April 2022 to April 2023 admitted to this hospital. According to the random number table method, they were divided into observation group and control group, 43 cases in each group. Both groups received routine patient-controlled intravenous analgesia after the surgery. On this basis, the control group received ultrasound-guided bilateral transversus abdominis plane block after the surgery, while the observation group received ultrasound-guided quadratus lumborum block after the surgery. The first pressing analgesia pump time, the first out-of-bed time, the total dosage of Sufentanil for patient-controlled intravenous analgesia, the visual analogue scale(VAS) score, and the incidence of adverse reactions were compared between the two groups. Results: The first pressing analgesia pump time in the observation group was longer than that in the control group, the first out-of-bed time in the observation group was shorter than that in the control group, the total dosage of Sufentanil in the observation group was less than that in the control group,and the differences were statistically significant(P<0.05). 2, 6 and 12 h after the surgery, the VAS scores of the observation group at rest and activity(cough)were lower than those of the control group, and the differences were statistically significant(P<0.05). Further, at 48 after the surgery, the incidence of adverse reactions in the observation group was 6.98%, which was lower than 23.26% in the control group, and the difference was statistically significant(P<0.05).Conclusions: Ultrasound-guided quadratus lumborum block for analgesia after gynecological laparoscopic surgery can shorten the first out-of-bed time,prolong the first pressing analgesia pump time, reduce the total dosage of Sufentanil for patient-controlled intravenous analgesia, and reduce the VAS scores and the incidence of adverse reactions. Moreover, it is superior to ultrasound-guided bilateral transversus abdominis plane block.更多还原