Effect of posterior quadratus lumborum blockade on the quality of recovery after major gynaecological laparoscopic surgery: A randomized controlled trial

Fujimoto, Hiroko; Irie, Tomoya; Mihara, Takahiro; Mizuno, Yusuke; Nomura, Takeshi; Goto, Takahisa

doi:10.1177/0310057x19838765

Cited by 26 publications

(20 citation statements)

References 19 publications

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“…The QoR-40 quality of recovery inventory has recently started to be used to assess quality of early postoperative recovery in numerous studies. While different surgical and anesthetic techniques have been employed, the effectiveness of the analgesia method employed has been evaluated with QoR-40 quality of recovery inventory 15 , 16 . We also employed QoR-40 together with VAS scores, postoperative fentanyl consumption, and numbers of patients using rescue analgesia.…”

Section: Discussionmentioning

confidence: 99%

The Effect of the Modified Thoracolumbar Interfascial Nerve Plane Block on Postoperative Analgesia and Healing Quality in Patients Undergoing Lumbar Disk Surgery: a Prospective, Randomized Study

Özmen¹,

İnce²,

Aksoy³

et al. 2019

MMJ

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Objective: The purpose of this study was to investigate the effect of the modified thoracolumbar interfascial plane block (TLIP) on postoperative analgesia and quality of recovery in patients undergoing lumbar disk surgery. Method: Ninety patients scheduled for lumbar disk surgery were divided into a control group (Group C) and a modified TLIP block group (Group T). Controlled analgesia was administered to both groups. Pain evaluation was performed at 30 min and at 1., 2., 4., 8.,12., and 24. hrs using a VAS scale, with patients at rest and duringand patients completed the QoR-40 quality of recovery inventory. Results: Fentanyl used during postoperative 24 hours was 742.5±220.3 mcg in Group C and 446.0±241.98 in Group T. Postoperative fentanyl consumption was statistically significantly lower in Group T (p<0.001) with a statistically significant intergroup difference. The patient's pain, physical independence, physical comfort, psychological support, and emotional support were compared using the QoR-40 questionnaire survey. Significant differences in favor of Group T were observed (p<0.001, p=0.017, p=0.002, p=0.001 and p<0.001, respectively). Static and dynamic pain scores in Group C and Group T were recorded at 30 min and at 1, 2, 4, 8, 12, and 24 h. Mean static scores were statistically significantly different in favor of Group T with the exception of 8 th and 12 h assessments (p<0.05). Dynamic scores were statistically significantly different in favor of Group T at all time points (p<0.05). Conclusion: Pain scores, opioid consumption and QoR-40 values after lumbar disk surgery were superior in the group undergoing TLIP. We think that the modified TLIP block may be an important method in terms of postoperative analgesia and patient recovery for lumbar spinal disk surgery.

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Section: Discussionmentioning

confidence: 99%

The Effect of the Modified Thoracolumbar Interfascial Nerve Plane Block on Postoperative Analgesia and Healing Quality in Patients Undergoing Lumbar Disk Surgery: a Prospective, Randomized Study

Özmen¹,

İnce²,

Aksoy³

et al. 2019

MMJ

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“…The authors suggested that the patients should be informed of the possibility of both numbness and weakness as the potential side-effects in their preoperative consent. [ 27 ] In the present study, no patient reported any adverse events. Similarly, the pain assessment and patient satisfaction score done at three months postoperatively were similar in both the groups.…”

Section: Discussionmentioning

confidence: 42%

To evaluate the effect of quadratus lumborum block on the tramadol sparing effect in patients undergoing open inguinal hernia surgery: A randomised controlled trial

et al. 2020

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Background and Aims: An ultrasound-guided quadratus lumborum (QL) block provides both somatic and visceral analgesia in abdominal surgeries. We aimed to evaluate the postoperative tramadol sparing effect of single-shot anterior QL block in inguinal hernia surgery patients. Methods: This prospective, randomised controlled trial was conducted in a single tertiary care centre over a period of 1 year. A total of 50 patients, American Society of Anaesthesiologists (ASA) physical status I–II of both sexes aged 18–80 years with body mass index (BMI) ≥20 to ≤35 kg/m 2 undergoing uncomplicated unilateral inguinal hernia surgery under spinal anaesthesia (SA) were randomly allocated to either of the two groups. The block group ( n = 25) received single-shot anterior QL block with 20 ml of 0.5% ropivacaine and the control group ( n = 25) received no block. Postoperatively, patients received intravenous (IV) paracetamol 1g every 6 h and tramadol patient-controlled analgesia up to 24 h. Primary outcome was total tramadol consumption at 24 h postoperatively. Results: The total tramadol consumption mean ± SD [95% CI (range)] at 24 h in the block group was 84.00 ± 37.86 [68.37–99.63 (20–160)] mg versus 93.60 ± 34.99 [79.16–108.04 (20–160)] mg in control group, (p value = 0.36). Postoperative VAS score, haemodynamics, and patient satisfaction score were similar in both the groups. No adverse events were reported. Conclusion: A single-shot anterior QL block did not establish a postoperative tramadol-sparing effect at 24 h as compared to no block in patients undergoing inguinal hernia surgery under SA.

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“…Although the pectoral nerve block improved pain score at 6 h postoperatively, the QoR-40 score on POD 1 was not improved. Fujimoto and colleagues [ 19 ] demonstrated no improvement in quality of recovery or postoperative analgesia for patients received single-shot posterior quadratus lumborum blockade (QLB) after laparoscopic gynecological surgery. The median QoR-40 score was 154 (133–168) in the QLB group and 158 (144–172) in the control group ( P = 0.361) respectively.…”

Section: Discussionmentioning

confidence: 99%

The impact of multimodal analgesia based enhanced recovery protocol on quality of recovery after laparoscopic gynecological surgery: a randomized controlled trial

Geng

Zhang

et al. 2021

BMC Anesthesiol

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Background Our objective was to evaluate the impact of multimodal analgesia based enhanced recovery protocol on quality of recovery after laparoscopic gynecological surgery. Methods One hundred forty female patients scheduled for laparoscopic gynecological surgery were enrolled in this prospective, randomized controlled trial. Participants were randomized to receive either multimodal analgesia (Study group) or conventional opioid-based analgesia (Control group). The multimodal analgesic protocol consists of pre-operative acetaminophen and gabapentin, intra-operative flurbiprofen and ropivacaine, and post-operative acetaminophen and celecoxib. Both groups received an on-demand mode patient-controlled analgesia pump containing morphine for rescue analgesia. The primary outcome was Quality of Recovery-40 score at postoperative day (POD) 2. Secondary outcomes included numeric pain scores (NRS), opioid consumption, clinical recovery, C-reactive protein, and adverse events. Results One hundred thirty-eight patients completed the study. The global QoR-40 scores at POD 2 were not significantly different between groups, although scores in the pain dimension were higher in Study group (32.1 ± 3.0 vs. 31.0 ± 3.2, P = 0.033). In the Study group, NRS pain scores, morphine consumption, and rescue analgesics in PACU (5.8% vs. 27.5%; P = 0.0006) were lower, time to ambulation [5.0 (3.3–7.0) h vs. 6.5 (5.0–14.8) h; P = 0.003] and time to bowel function recovery [14.5 (9.5–19.5) h vs.17 (13–23.5) h; P = 0.008] were shorter, C-reactive protein values at POD 2 was lower [4(3–6) ng/ml vs. 5 (3–10.5) ng/ml; P = 0.022] and patient satisfaction was higher (9.8 ± 0.5 vs. 8.8 ± 1.2, P = 0.000). Conclusion For minimally invasive laparoscopic gynecological surgery, multimodal analgesia based enhanced recovery protocol offered better pain relief, lower opioid use, earlier ambulation, faster bowel function recovery and higher patient satisfaction, while no improvement in QoR-40 score was found. Trial registration ChiCTR1900026194; Date registered: Sep 26,2019.

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Effect of posterior quadratus lumborum blockade on the quality of recovery after major gynaecological laparoscopic surgery: A randomized controlled trial

Cited by 26 publications

References 19 publications

The Effect of the Modified Thoracolumbar Interfascial Nerve Plane Block on Postoperative Analgesia and Healing Quality in Patients Undergoing Lumbar Disk Surgery: a Prospective, Randomized Study

The Effect of the Modified Thoracolumbar Interfascial Nerve Plane Block on Postoperative Analgesia and Healing Quality in Patients Undergoing Lumbar Disk Surgery: a Prospective, Randomized Study

To evaluate the effect of quadratus lumborum block on the tramadol sparing effect in patients undergoing open inguinal hernia surgery: A randomised controlled trial

The impact of multimodal analgesia based enhanced recovery protocol on quality of recovery after laparoscopic gynecological surgery: a randomized controlled trial

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