天津医药 ›› 2023, Vol. 51 ›› Issue (3): 286-289.doi: 10.11958/20221185
孙高悦(
), 钟晓倩, 张倩倩, 李云()
SUN Gaoyue(), ZHONG Xiaoqian, ZHANG Qianqian, LI Yun()
摘要： Objective To evaluate the effect of ultrasound-guided modified thoracolumbar interfascial plane (mTLIP) block on the quality of recovery (QoR) in patients undergoing lumbar decompression and fusion. Methods Sixty patients undergoing lumbar decompression and fusion were divided into two groups (n=30) by a random number table method: the mTLIP block group (group T) and the control group (group C). The patients in the group T were injected with 0.4% ropivacaine 20 mL+20 μg dexmedetomidine between longissimus and iliocostalis muscles at the third lumbar spine vertebral level on each side under ultrasound guidance, while patients in the group C were not received nerve block. All patients received patient controlled intravenous analgesia (PCIA) after operation. When patients had a postoperative pain numerical rating scale (NRS) ≥4, flurbiprofen ester 50 mg was given intravenously for remedial analgesia. The QoR-15 scores of patients in both groups were recorded before and 24 hours after operative. The NRS scores for pain in both groups were recorded at 0.5, 2, 6, 12, 24 and 48 hours postoperatively. The area under curve (AUC) of NRS scores at rest and at activity at 24 hours after surgery, the patient satisfaction scores, PCIA press times and the use of remedial analgesia at 24 h after operation, postoperative nausea and vomiting were also recorded. Results Compared with the group C, patients in the group T had higher QoR-15 scores at 24 hours postoperatively, higher patient satisfaction scores, lower NRS scores at rest and at activity at 0.5 h, 2 h, 12 h, 24 h and 48 h postoperatively, lower AUC, fewer PCIA press times and lower rate of remedial analgesia at rest and at activity (P<0.05). Conclusion Ultrasound-guided dexmedetomidine compounded with ropivacaine for modified thoracolumbar fascial plane nerve block can improve the quality of postoperative recovery in patients undergoing lumbar decompression and fusion, relieve postoperative pain, improve patient satisfaction and promote early postoperative recovery.
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