腰方肌前路阻滞对腹部和背部各区域的阻滞效果

Efficacy of anterior approach to quadratus lumborum block in each abdominal and back region

【摘要】目的评价腰方肌前路阻滞对腹部和背部各区域的阻滞效果。方法健康志愿者12名，年龄18～45岁，性别不限，ASA分级I或Ⅱ级，BMI18～30kg／m2，超声引导下行腰方肌前路阻滞，阻滞用药为0．375％罗哌卡因注射液20ml。采用冷温法测试腹部和背部各区域（以体表标志线将右侧躯体划分为15个区域）阻滞情况，记录注药后30min时各区域阻滞阳性情况。结果≤5％阳性率区域为0；〉5％～20％阳性率区域为1区、13区；〉20％～50％阳性率区域为2区、3区、4区；〉50％～70％阳性率区域为6区、7区、10区；〉70％～〈95％阳性率区域为5区、14区、15区；≥95％阳性率区域为8区、9区、11区、12区。结论腰方肌前路阻滞对阻滞侧前腹壁中下部区域阻滞有效。

Objective To evaluate the efficacy of the anterior approach to quadratus lumborum block in each abdominal and back region. Methods Twelve healthy volunteers of both sexes, aged 18-45 yr, of American Society of Anesthesiologists physical status I or 11 , with body mass index of 18-30 kg/m2 , were enrolled in the study. Quadratus lumborum block was performed via the anterior approach un- der the guidance of ultrasound with 0. 375% ropivacaine 20 ml. The block was assessed by cold stimulation （ice cake） in each abdominal and back region （the right side of the body was divided into 15 regions using the anatomical ＂landmarks＂ on the body surface）. The positive condition in each region was recorded at 30 rain after administration. Results The region in which the positive rate ~〈 5% was 0. The regions in which the positive rate 〉5%-20% were 1 and 13 regions. The regions in which the positive rate 〉20%-50% were 2, 3 and 4 regions. The regions in which the positive rate 〉50%-70% were 6, 7 and 10 regions. The re- gions in which the positive rate 〉70%-〈95% were 5, 14 and 15 regions. The regions in which the positive rate ≥95% were 8, 9, 11 and 12 regions. Conclusion The anterior approach to quadratus lumborum block is effective in the middle-lower region of the anterior abdominal wall on the blocked side.