腰方肌阻滞用于妇产科手术术后镇痛的Meta分析

Quadratus Lumborum Block on Postoperative Analgesia in Patients Experiencing Gynecological and Obstetrical Surgery:A Meta-analysis

目的:评价腰方肌阻滞用于妇产科手术术后镇痛的临床疗效。方法:检索PubMed、Cochrane Library、Embase、万方、知网等数据库,收集2009年1月1日-2020年2月1日有关于腰方肌阻滞应用于妇产科手术的临床随机对照研究,采用RevMan 5.3进行Meta分析。结果:共检索到418篇临床研究文献,最终纳入8篇相关临床随机对照研究,538例患者,Meta分析结果,与对照组相比,腰方肌阻滞组的患者术后阿片类镇痛药用量减少[MD=-5.75,95%CI(-9.11,-2.39),P<0.05],术后24 h静息[SMD=-0.51,95%CI(-0.74,-0.27),P<0.05]和运动[SMD=-0.63,95%CI(-0.93,-0.33),P<0.05]疼痛评分降低,术后恶心呕吐发生率降低[OR=0.60,95%CI(0.37,0.98),P<0.05],差异均有统计学意义(P<0.05)。结论:腰方肌阻滞用于妇产科手术术后镇痛,能够缓解术后疼痛,给妇产科手术术后多模式镇痛提供选择。

Objective:To evaluate the clinical efficacy of quadratus lumborum block in postoperative analgesia of gynecological and obstetrical surgery.Method:Randomized controlled trials of the quadratus lumborum block in patients experiencing gynecological and obstetrical surgery published from January 1,2009 to February 1,2020 were collected by searching databases including the PubMed,the Cochrane Library,Embase,WanFang Data,CNKI.A meta-analysis was performed by RevMan 5.3.Result:418 clinical studies were retrieved,and 8 RCTs involving 538 patients were included.The results of meta-analysis showed that compared with the control group,in the QLB group,the dosage of 24 h post-surgery opioid analgesic was significantly reduced[MD=-5.75,95%CI (-9.11,-2.39),P<0.05].At 24 h post-surgery,the pain score was lower at resting[SMD=0.51,95%CI (0.74,0.27),P<0.05]and during exercise[SMD=0.63,95%CI (0.93,0.33),P<0.05].The incidence of postoperative nausea and vomiting was reduced[OR=0.60,95%CI (0.37,0.98),P<0.05],the differences were statistically significant (P<0.05).Conclusion:The application of quadratus lumborum block in postoperative analgesia of gynecological and obstetrical surgery can relieve postoperative pain,provide options for postoperative multi-mode analgesia of gynecological and obstetrical surgery.