Đánh giá hiệu quả giảm đau sau phẫu thuật thay khớp háng của phương pháp gây tê cơ vuông thắt lưng liên tục dưới hướng dẫn siêu âm

Abstract

Our study aimed to assess the analgesic efficacy and the side effects of continuous quadratus lumborum block in hip replacement surgery. The study enrolled 30 patients who underwent hip replacement surgery. All patients were relieved of postoperative pain by continuous quadratus lumborum (QL) block according to ultrasound guidance at Center of Anesthesia & Surgical Intensive Care, Viet Duc Hospital, from April 2019 to August 2019. Sensory blockade, VAS points at rest and during exercise, patient satisfaction, and amount of morphine consumed were recorded during 48 hours post-surgery. The average time of procedure was 16,03 ± 2,80 (min). All patients  had blockade of iliohypogastric - ilioinguinal nerves, 96.7% had blockade of femoral nerve & lateral cutaneous nerve of thigh, 70% had blockade of genitofemoral nerve, and 50% had blockade of obturator nerve. Mean VAS scores at rest and knee flexion at 45 degrees were below 4 points  in the 48 hours post-surgery.  The majority (96.7%) of the patients were very satisfied and satisfied with their treatment; one patient had to be rescued with PCA morphin. Mean VAS scores at rest were below 3 points and during exercise were approximately 4 points during 48 hours postoperative. There was one patient who had to be rescued with PCA morphin and 96.7% of patients have satisfied level. Our study showed that ultrasound-guided continuous lumborum quadratus block was efficient for postoperative pain management in hip replacement surgery.