A comparative study of transversus abdominis plane block versus quadratus lumborum block for postoperative analgesia following lower abdominal surgeries: A prospective double-blinded study

Kumar, Gunjan; Gnanasekar, N; Kurhekar, Pranjali; Prasad, T Krishna

doi:10.4103/aer.aer_158_18

Cited by 26 publications

(7 citation statements)

References 19 publications

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“…Twenty-two studies [6,[15][16][17][18][19][20] on effects of TAPB vs. QLB in postoperative analgesia were included in this meta-analysis. Overall results showed that QLB showed more effective analgesia than TAPB in regards to morphine consumption, fentanyl consumption, VAS score at 24 h postoperatively, the number of patients requiring analgesia postoperatively, and the incidence of dizziness.…”

Section: Discussionmentioning

confidence: 99%

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Effects of transversus abdominis plane block versus quadratus lumborum block on postoperative analgesia: a meta-analysis of randomized controlled trials

Wang

Zhang

2020

BMC Anesthesiol

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Background Trunk block technique has been used in postoperative analgesia for patients undergoing surgery, specifically, transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) have been proved effective. The purpose of this meta-analysis is to evaluate the effects of TAPB and QLB in postoperative analgesia. Methods Online databases, including MEDLINE, EMBASE, Cochrane Library (&Trail), Web of Science, CNKI, Wanfang and QVIP were applied to collect the randomized controlled trials (RCTs) from inception to Dec. 9th, 2019. Twenty-two studies were finally included containing 777 patients in the TAPB group and 783 cases in QLB group. RCTs comparing TAPB and QLB in postoperative analgesia were included in this meta-analysis. The indicators including total analgesia consumption postoperatively, operative time, duration of anesthesia, visual analogue scale (VAS) score at 24 h postoperatively, duration of postoperative analgesia, the number of patients requiring analgesia postoperatively and adverse reactions were analyzed. Results our findings showed that morphine consumption (mg) (WMD = 3.893, 95%CI: 2.053 to 5.733, P < 0.001), fentanyl consumption (μg) (WMD = 23.815, 95%CI: 15.521 to 32.109, P < 0.001), VAS score at 24 h postoperatively (WMD = 0.459, 95%CI: 0.118 to 0.801, P = 0.008), the number of patients requiring analgesia postoperatively (WMD = 3.893, 95%CI: 2.053 to 5.733, P < 0.001), and the incidence of dizziness (WMD = 2.691, 95%CI: 1.653 to 4.382, P < 0.001) in TAPB group were higher than in QLB group. Conclusions QLB is superior to TAPB in reducing morphine consumption, fentanyl consumption, VAS score at 24 h postoperatively, the number of patients requiring analgesia postoperatively, and the incidence of dizziness.

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Section: Discussionmentioning

confidence: 99%

“…In recent years, many randomized controlled trials (RCTs) have been conducted to compare the effects of TAPB and QLB in postoperative analgesia [6,[15][16][17][18]. However, the results of outcomes of postoperative analgesia were inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Effects of transversus abdominis plane block versus quadratus lumborum block on postoperative analgesia: a meta-analysis of randomized controlled trials

Wang

Zhang

2020

BMC Anesthesiol

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“…34 Interestingly, an RCT examining various abdominal surgeries identified a similar trend with rescue analgesia, suggesting potential broader applications for QLB's benefits. 44 While transient pain reduction has evident benefits, it is also crucial to consider the broader implications, especially in the current opioid crisis in the US. In light of this, there is an urgent need to reduce postoperative opioid consumption, particularly given that several studies indicate postoperative opioid use can potentially lead to chronic opioid dependence.…”

Section: Discussionmentioning

confidence: 99%

Quadratus lumborum block versus transversus abdominis plane block for inguinal hernia repair: A systematic review and meta‐analysis with trial sequential analysis

Marcolin,

Amaral,

Motter

et al. 2024

World j. surg.

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IntroductionPostoperative pain management is crucial for patient recovery with Quadratus Lumborum Block (QLB) and Transversus Abdominis Plane Block (TAPB) emerging as potential techniques. We aimed to compare the analgesic efficacy of QLB and TAPB in patients undergoing inguinal hernia repair.MethodsWe performed a systematic review of Cochrane, EMBASE, and MEDLINE databases to identify randomized controlled trials comparing QLB and TAPB in patients undergoing inguinal hernia repair. Outcomes included postoperative pain and opioid consumption. Statistical analysis was performed using RevMan 5.4. The review protocol was registered at PROSPERO (CRD42023445513).ResultsWe included five RCTs encompassing 255 patients. QLB was associated with a significant decrease in postoperative pain (MD −0.45; 95% CI −0.75 to −0.14; and p = 0.004; I2 = 94%). However, we found no difference in 24‐h opioid consumption between QLB and TAPB groups.ConclusionQLB may offer superior pain reduction. However, its effect on opioid consumption remains unclear.

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“…2,3 Similarly but not identically, quadratus lumborum block (QLB) is a more effective technique, providing more potent and prolonged postoperative analgesia in comparison with the TAPB, 5 and is conductive to reducing opioid use. 6 Several cadaveric studies have shown that the solution used in QLB may spread to the paravertebral space, the nerve roots, and the spinal nerve, which runs anterior to the quadratus lumborum muscle, 5,[7][8][9][10][11] covering the operative area for most of the abdomen and pelvis surgeries. 12 With the growing interest in the use of QLB for postoperative analgesia of laparoscopic myomectomy, more studies are needed to determine an optimal medication scheme to improve the analgesic effect.…”

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confidence: 99%

“…Several studies have shown that transversus abdominis plane block (TAPB) contributes to less postoperative pain,2 less postoperative nausea and vomiting,3 and earlier removal of urinary catheter4 in laparoscopic gynecologic surgery and other abdominal surgery in comparison with epidural analgesia4 or placebo 2,3. Similarly but not identically, quadratus lumborum block (QLB) is a more effective technique, providing more potent and prolonged postoperative analgesia in comparison with the TAPB,5 and is conductive to reducing opioid use 6…”

mentioning

confidence: 99%

Impact of Bilateral Quadratus Lumborum Block Using Different Doses of Dexmedetomidine for Postoperative Analgesia in Laparoscopic Myomectomy

Zhang

Jiao

et al. 2023

The Clinical Journal of Pain

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Objectives: The optimal dosage of dexmedetomidine (DEX) for postoperative analgesia of quadratus lumborum block (QLB) after laparoscopic myomectomy is not clear. Our study evaluated the analgesic and adverse effects of different doses of locally administered DEX.Materials and Methods: Patients underwent laparoscopic myomectomy were enrolled in this randomized controlled trial. Transmuscular bilateral QLB was conducted postoperatively using local anesthetic plus different doses of DEX, as an adjuvant, per side. Numeric rating scales (NRS) of pain score and heart rate (HR) were assessed after performing QLB. Additional analgesics through patient-controlled analgesia pump, recovery time to first flatus, hospital stay, and other outcomes were also compared.Results: A total of 150 participants were randomly divided into 3 groups (DEX1 group: 0.1 μg/kg; DEX2 group: 0.3 μg/kg; DEX3 group: 0.5 μg/kg), 50 for each group. Compared with the DEX1 group, NRS pain scores were lower in groups DEX2 and DEX3 (P < 0.017) 20 minutes after QLB and the significance lasted for 24 hours. Patients in groups DEX2 and DEX3 needed fewer additional analgesics than the group DEX1 (P < 0.017). HR in groups DEX2 and DEX3 was lower than the group DEX1 10 minutes and 20 minutes after QLB, respectively (P < 0.017). Sixty minutes after QLB, HR in the DEX3 group was still lower than the other groups. More patients in the DEX3 group were found bradycardia. Satisfaction score of postoperative analgesia was higher in groups DEX2 and DEX3 than the DEX1 group (P < 0.017).Discussion: The results suggest that solution of DEX 0.3 μg/kg in ropivacaine 0.25% for QLB is recommended to relieve postoperative pain after laparoscopic myomectomy effectively and safely.

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A comparative study of transversus abdominis plane block versus quadratus lumborum block for postoperative analgesia following lower abdominal surgeries: A prospective double-blinded study

Cited by 26 publications

References 19 publications

Effects of transversus abdominis plane block versus quadratus lumborum block on postoperative analgesia: a meta-analysis of randomized controlled trials

Effects of transversus abdominis plane block versus quadratus lumborum block on postoperative analgesia: a meta-analysis of randomized controlled trials

Quadratus lumborum block versus transversus abdominis plane block for inguinal hernia repair: A systematic review and meta‐analysis with trial sequential analysis

Impact of Bilateral Quadratus Lumborum Block Using Different Doses of Dexmedetomidine for Postoperative Analgesia in Laparoscopic Myomectomy

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