Study on the application of ultrasound-guided quadratus lumborum block combined with general anesthesia in elderly patients undergoing laparoscopic radical nephrectomy
Sun Xiaojia
Wang Yeming
Meng Chenxue
Liu Yumeng
Zhao Lichun
Zhao Jibo
Abstract：Objective To analyze the application effect of ultrasound-guided quadratus lumborum block combined with general anesthesia in elderly patients undergoing laparoscopic radical nephrectomy.Methods Sixty elderly patients with renal cell carcinoma admitted to the First Affiliated Hospital of Hebei North University from August 2021 to August 2022 were selected.All patients underwent laparoscopic radical nephrectomy and were divided into G group and OSA group by random number table method.Patients in G group received conventional opioid general anesthesia,and patients in OSA group received ultrasound-guided quadratus lumborum block combined with opioid general anesthesia.The dosage of anesthetic drugs,sedative and analgesic effects,serum pain factor levels,sleep quality and cognitive function were compared between the two groups.Results The intraoperative consumptions of remifentanil and propofol in OSA group were significantly lower than that in G group[(1.12±0.22)mg vs(1.36±0.31)mg,(513±9)mg vs(533±9)mg],and the pressing times of analgesic pump and the requirement for rescue analgesia within 24 h after operation were significantly less/lower than those in G group[(3.3±0.8)times vs(7.6±1.0)times,13.3％(4/30)vs 36.7％(11/30)](all P＜0.05).The resting visual analogue scale(VAS)score and active VAS score in OSA group were lower than those in G group at 12,24 and 48 h after surgery,and the Ramsay sedation score was higher than that in G group(all P＜0.05).The serum levels of substance P,β-endorphin and nitric oxide in OSA group were lower than those in G group at 12,24 and 48 h after operation(all P＜0.05).The Mini-Mental State examination scores of OSA group were higher than those of G group at 12,24 and 48 h after operation,and the Pittsburgh sleep quality index scores were lower than those of G group(all P＜0.05).Conclusion Ultrasound-guided quadratus lumborum block combined with general anesthesia can reduce the use of anesthetic drugs,effectively regulate the expression of serum pain factors,have better sedative and analgesic effects,and reduce the impact of surgery on sleep quality and cognitive function in elderly patients undergoing laparoscopic radical nephrectomy.
Keywords：Laparoscopic radical nephrectomyUltrasound-guided quadratus lumborum blockGeneral anesthesia
Publication Date：2025-10-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1524-1528 )