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To investigate the effect of ultrasound-guided lateral quadratus lumborum block（QLB-1）on the median effective dosage（ED50）of butorphanol by patient controlled intravenous analgesia（PCIA）performed after cesarean section under general anesthesia.
Parturients were scheduled for cesarean section under general anesthesia,gestation 37-42 weeks, ASA physical status Ⅱ were assigned into two groups, group Q（QLB-1 combined with butorphanol PCIA）and group C（butorphanol PCIA）. Each group was expected to have 35 cases. Both groups were administered general anesthesia with endotracheal intubation. The group Q: 0.3% ropivacaine with 25 mL were injected in the QLB-1 in each side respectively under ultrasound guidance before extubation at the end of the surgery. The group C: no nerve block.The two groups underwent PCIA after extubation. The scores of resting visual analogue scale（VAS）≤3 points or VAS of motion state ≤4 points within 48 hours after operation were used as the criteria of analgesia satisfaction. The initial dose of butorphanol with PCIA was 4 μg·kg-1·h-1, adjusted by the modified Dixon’s up-and-down method with a dose gradient of 0.25 μg·kg-1·h-1. Probit analysis was used for calculating ED50 and 95% confidence interval（CI）of butorphanol PCIA for satisfactory analgesia.
The sample size included in group Q and group C were 31 and 28 cases, respectively.The ED50 of butorphanol PCIA for satisfactory analgesia was 3.81 μg·kg-1·h-1 for the group C（95%CI: 2.87 to 4.25 μg·kg-1·h-1）and 2.45 μg·kg-1·h-1 for the group Q（95%CI: 2.16 to 2.70 μg·kg-1·h-1）. In the parturients with satisfactory analgesia of the two groups, the incidence of drowsiness, dizziness and nausea was higher in the group C than that in the group Q（P<0.05）.
The ED50 of butorphanol PCIA combined with QLB-1 for satisfactory relieve postoperative analgesia after cesarean section under general anesthesia reduce butorphanol PCIA alone by 36% and reduce the incidence of adverse reactions.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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