Quadratus lumborum block versus transversus abdominis plane block for postoperative pain management after laparoscopic colorectal surgery

Abstract

Background: This study aimed to compare the quadratus lumborum block (QLB) method with transversus abdominis plane block (TAPB) for postoperative pain management in patients undergoing laparoscopic colorectal surgery. Methods: Seventy-four patients scheduled for laparoscopic colorectal surgery were randomly assigned into 2 groups. After surgery, patients received bilateral ultrasound-guided single-dose of QLB or TAPB. Each side was administered with 20 ml of 0.375% ropivacaine. All patients received sufentanil as patient-controlled intravenous analgesia (PCIA). Resting and moving numeric rating scale (NRS) were assessed at 2, 4, 6, 24, 48 hours postoperatively. The primary outcome measure was sufentanil consumption at predetermined time intervals after surgery. Results: Patients in the QLB group used significantly less sufentanil than TAPB group at 24 and 48 hours (P < .05), but not at 6 hours (P = .33) after laparoscopic colorectal surgery. No significant differences in NRS results were found between the two groups at rest or during movement (P > .05). Incidence of dizziness in the QLB group was lower than in TAPB group (P < .05). Conclusions: The QLB is a more effective postoperative analgesia as it reduces sufentanil consumption compared to TAPB in patients undergoing laparoscopic colorectal surgery.

Effect of Ultrasound-Guided Quadratus Lumborum Block Preemptive Analgesia on Postoperative Recovery of Patients with Open Radical Colon Cancer Surgery: A Retrospective Study

“…37,38 So, we preferred to choose QLB3 in our hospital. Results showed that the VAS scores of rest pain and active pain within 48 h postoperatively in Group Q were significantly lower than those in Group C (P<0.01), which is very similar to that of Deng et al 39 that the QLB is a more effective postoperative analgesia in patients undergoing laparoscopic colorectal surgery, and which is consistent with the results of Kukreja et al 31 indicating that QLB preemptive analgesia complies with the concept of multimodal analgesia: using analgesic drugs that have different mechanisms can create an additive or synergistic effect, thereby enhancing the analgesic efficacy. 40,41 QLB preemptive analgesia can block part of visceral pain by blocking part of the sympathetic nerve, reduce incision pain by blocking nerve fiber impulse conduction, and inhibit the release of inflammatory factors by reducing or preventing stress response, so as to reduce inflammatory pain.…”

Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial

“…The quadratus lumborum block (QLB) was first described by Blanco in 2007, and later was subdivided into three basic approaches known as QLB1, 2, and 3, as well as a modified approach called intramuscular QLB, each based on needle tip position and the spread of local anesthetic (LA) [1]. Recently, numerous case reports and randomized trials have shown that QLB may be effective in relieving postoperative pain and providing an opioidsparing effect after various surgical procedures [2][3][4][5][6][7][8][9][10].…”

Ultrasound-guided Quadratus Lumborum Block for Perioperative Analgesia in Robot-assisted Partial Nephrectomy: A Randomized Controlled Trial

“…Ultrasound-guided QLB technique was first described by Blanco [11,12], and the benefits of QLB for postoperative pain relief and opioids-sparing effect have been reported by several randomized controlled trials and case reports [2,5,6,[8][9][10][19][20][21][22][23][24][25][26][27][28][29][30]. All approaches have been proved the synergistic efficacy for multimode analgesia, especially for QLB2 or QLB3 after laparoscopic surgery, cesarean section and total hip arthroplasty.…”

“…The quadratus lumborum block (QLB) was first described by Blanco in 2007, which later can be subdivided into three basic approaches, known as QLB1, 2, 3 and a modified approach, called intramuscular QLB, based on needle tip position and the spread of local anesthetic (LA) [1]. Recently, an increasing case reports and randomized trials have show that QLB may be effective in postoperative pain relief and opioids-sparing effect after various surgery operations [2][3][4][5][6][7][8][9][10].…”