Quadratus lumborum block (transmuscular approach) versus transversus abdominis plane block (unilateral subcostal approach) for perioperative analgesia in patients undergoing open nephrectomy: a randomized, double-blinded, controlled trial

Efficacy of quadratus lumborum block on postoperative pain and side effects in patients who underwent urological surgery: A meta‐analysis

“…All 13 RCTs were compared between the QLB and control groups and reported in English. Among these, of the RCTs involved laparoscopic nephrectomy, 16–21 two RCTs involved open nephrectomy, 22,23 three RCTs involved percutaneous nephrolithotomy, 24–26 one RCT involved kidney transplantation, 27 and one RCT involved extracorporeal shock wave lithotripsy 28 . In 10 RCTs, the anterior QLB was applied, in which local anesthetics were injected between the psoas major and quadratus lumborum muscles 16,17,20–26,28 .…”

“…28 In 10 RCTs, the anterior QLB was applied, in which local anesthetics were injected between the psoas major and quadratus lumborum muscles. 16,17,[20][21][22][23][24][25][26]28 In 3 RCTs, the technology of lateral QLB was applied, 18,19,27 in which local anesthetics were injected at the lateral to the quadratus lumborum muscle. Table 1 lists the main characteristics of the included trials.…”

“…Overall, postoperative pain scores during movement at 0 h, 19,22,23,27 6 h, 18,19,22,23 12 h, 19,22,23,27 and 24 h 18,19,22,27 were reported in 4 studies for each time point. Compared with the control group, the QLB group had significantly lower postoperative pain scores during movement at 0 h (MD, −1.71; 95% CI, −2.82 to −0.59; I 2 = 94%; p = 0.003), 6 h (MD, −1.22; 95% CI −1.49 to −0.94; I 2 = 15%; p < 0.00001), 12 h (MD, −1.01; 95% CI, −1.76 to −0.27; I 2 = 92%; p = 0.008), and 24 h (MD, −0.99; 95% CI, −1.60 to −0.38; I 2 = 78%; p = 0.001) (Figure 4).…”

“…Nine studies reported the incidence of PONV. [16][17][18][19][20][21]23,24,26 In the QLB group, the incidence of PONV was significantly reduced compared with the control group (OR, 0.38; 95% CI, 0.22 to 0.63; I 2 = 16%; p = 0.0002) (Figure 6).…”

Letter to the Editor Regarding “Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study”

“…Third, both ESPB and oblique subcostal TAPB were performed before general anesthesia, which was induced with sufentanil and propofol, and maintained using 1.5-2% sevoflurane and remifentanil 0.1-0.2 lg/kg/min. However, the authors did not compare intraoperative opioid consumption in the two groups, unlike previous studies assessing perioperative analgesic efficacy of nerve blocks in patients undergoing abdominal surgery [5][6][7]. Because of this design limitation, an important issue that this study cannot answer is whether the ESPB provides a more intraoperative opioid sparing than the oblique subcostal TAPB does.…”