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已发表论文
超声引导与双引导（超声联合神经刺激）肋下腰方肌阻滞在腹膜后腹腔镜肾切除术中的效果比较：一项随机对照试验
Authors Li H , Xu S, Shi R, Shao P, Ma D, Guo R , Jin X, Wang Y
Received 17 September 2025
Accepted for publication 21 December 2025
Published 26 December 2025 Volume 2025:18 Pages 7149—7158
DOI https://doi.org/10.2147/JPR.S396086
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Karina Gritsenko
Huili Li,1,* Songchao Xu,1,* Rong Shi,2 Peiqi Shao,1 Danxu Ma,1 Ruijuan Guo,1 Xiaoping Jin,1 Yun Wang1
1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China; 2Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yun Wang, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Beijing, 100050, People’s Republic of China, Email wangyun129@ccmu.edu.cn Xiaoping Jin, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China, Email xiaopingjin@sina.com
Objective: To compare the effectiveness of ultrasound (US) guidance alone versus combined nerve stimulation (NS) and US in subcostal quadratus lumborum block (SQLB) for patients undergoing laparoscopic nephrectomy.
Methods: Eighty-four patients scheduled for laparoscopic nephrectomy were randomized to receive a SQLB with either US alone (US group) or combined US and NS guidance (US-NS group). Each patient received 25 mL of 0.5% ropivacaine for the block. The primary endpoint was the block success rate within 5 minutes after block. Secondary endpoints included the extent of sensory block, intravenous morphine equivalent consumption, NRS scores, frequency of rescue analgesia administration, puncture time, number of needle insertion attempts, ultrasonic images quality, and incidence of adverse reactions and complications.
Results: The US-NS group demonstrated significantly higher block success rate compared to the US group (92.5% vs 62.5%, P < 0.05). Additionally, the US-NS group exhibited lower opioid requirements and fewer rescue analgesia interventions within the initial 24-hour postoperative period, broader sensory block coverage at 5, 10, and 15 minutes following injection, and lower NRS scores both at rest and during coughing at 6, 12, 24, and 48 hours post-surgery. However, the US-NS group required a longer puncture duration and more attempts to complete the SQLB. No significant differences were found between the two groups regarding the quality of ultrasound images and the incidence of adverse effects.
Conclusion: Dual guidance with NS and US was superior to US alone for performing SQLB, resulting in higher block success rates and improved analgesic efficacy for laparoscopic nephrectomy.
Keywords: subcostal quadratus lumborum block, ultrasound guidance, nerve stimulation, laparoscopic nephrectomy
1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China; 2Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yun Wang, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Beijing, 100050, People’s Republic of China, Email wangyun129@ccmu.edu.cn Xiaoping Jin, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China, Email xiaopingjin@sina.com
Objective: To compare the effectiveness of ultrasound (US) guidance alone versus combined nerve stimulation (NS) and US in subcostal quadratus lumborum block (SQLB) for patients undergoing laparoscopic nephrectomy.
Methods: Eighty-four patients scheduled for laparoscopic nephrectomy were randomized to receive a SQLB with either US alone (US group) or combined US and NS guidance (US-NS group). Each patient received 25 mL of 0.5% ropivacaine for the block. The primary endpoint was the block success rate within 5 minutes after block. Secondary endpoints included the extent of sensory block, intravenous morphine equivalent consumption, NRS scores, frequency of rescue analgesia administration, puncture time, number of needle insertion attempts, ultrasonic images quality, and incidence of adverse reactions and complications.
Results: The US-NS group demonstrated significantly higher block success rate compared to the US group (92.5% vs 62.5%, P < 0.05). Additionally, the US-NS group exhibited lower opioid requirements and fewer rescue analgesia interventions within the initial 24-hour postoperative period, broader sensory block coverage at 5, 10, and 15 minutes following injection, and lower NRS scores both at rest and during coughing at 6, 12, 24, and 48 hours post-surgery. However, the US-NS group required a longer puncture duration and more attempts to complete the SQLB. No significant differences were found between the two groups regarding the quality of ultrasound images and the incidence of adverse effects.
Conclusion: Dual guidance with NS and US was superior to US alone for performing SQLB, resulting in higher block success rates and improved analgesic efficacy for laparoscopic nephrectomy.
Keywords: subcostal quadratus lumborum block, ultrasound guidance, nerve stimulation, laparoscopic nephrectomy