Ultrasound Guided Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Post-operative Analgesia in Patients Undergoing Total Abdominal Hysterectomy

Naaz, Shagufta; Kumar, Rajesh; Ozair, Erum; Sahay, Nishant; Asghar, Adil; Jha, Sangam; Akhil, VP

doi:10.5152/tjar.2021.985

Cited by 13 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, the NRS score was higher in Group T at all time intervals and significantly higher at the fourth and sixth hour (P < 0.05) than Group Q. This was similar to the study done by Naaz et al, who compared the ultrasound-guided QL block and TAP block in patients undergoing TAH under general anaesthesia [11]. They found that the QL block group had a significantly better visual analogue scale (VAS) score from 6 till 24 hr postoperatively.…”

Section: Discussionsupporting

confidence: 91%

A Comparative Study of Ultrasound-Guided Quadratus Lumborum Block and Transversus Abdominis Plane Block for Postoperative Analgesia Following Total Abdominal Hysterectomy

Shukla¹,

Yadav²,

Duggal³

2023

Cureus

View full text Add to dashboard Cite

Background: Total abdominal hysterectomy (TAH) results in remarkable postoperative pain. Truncal nerve blocks like the quadratus lumborum (QL) block and transversus abdominis plane (TAP) block are described to combat this pain. The aim of the present study was to compare the effectiveness of the QL block with the TAP block in terms of numeric rating scale (NRS) scores as the primary outcome for postoperative pain in TAH. The secondary outcome was time of the first analgesic demand, total analgesic demands required in 24 hr, and patient satisfaction level.Methods: Seventy patients of American Society of Anesthesiologists (ASA) physical status class I and II, aged 35-65 years with a body mass index (BMI) 18-30 kg/m 2 planned for elective TAH under spinal anaesthesia were randomly allocated into two groups. Group Q received QL block and Group T received TAP block under ultrasound guidance with 40 ml of 0.25% bupivacaine of which 20 ml was injected on either side.Results: Demographic data of both groups was comparable. The NRS pain score was significantly lower in Group Q compared to Group T at the fourth and sixth hour. The mean first analgesic demand was significantly early in Group T compared to Group Q (5.69 ± 0.87 hr vs. 11.23 ± 2.22 hr) and total analgesic demands were significantly greater in Group T than Group Q. The mean patient satisfaction score was significantly high in Group Q compared to Group T (5.8 ± 0.41 vs. 4.74 ± 0.44). Conclusion:The combined posterior and anterior approach of the QL block may represent a more efficacious alternative to the TAP block in patients after TAH. Further studies are recommended to evaluate the ideal dose, volume and approach for the QL block.

show abstract

Section: Discussionsupporting

confidence: 91%

A Comparative Study of Ultrasound-Guided Quadratus Lumborum Block and Transversus Abdominis Plane Block for Postoperative Analgesia Following Total Abdominal Hysterectomy

Shukla¹,

Yadav²,

Duggal³

2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Regional anesthesia is an essential component of multimodal pain control after pediatric surgery [2]. The QLB has gained popularity as a non-opioid adjunct in lower abdominal surgery, owing to superior analgesia and avoidance of neuraxial access [10][11][12]. While several studies have demonstrated the utility of the QLB in urological surgery and gynecological procedures [13][14][15][16][17], limited reports exist to describe its application in pediatric colorectal patients.…”

Section: Discussionmentioning

confidence: 99%

Quadratus Lumborum Blockade for Postoperative Analgesia in Infants and Children Following Colorectal Surgery

et al. 2023

View full text Add to dashboard Cite

Background: Adult studies have indicated that the quadratus lumborum block (QLB) may provide superior analgesia compared to singleshot neuraxial and other truncal peripheral nerve blocks. The technique is being increasingly used for postoperative analgesia in children undergoing lower abdominal surgery. To date, these pediatric reports have been limited by small sample sizes, which may hinder the interpretation of results and assessment of safety. In this study, we retrospectively examined QLBs performed at a large tertiary care hospital for evidence of effectiveness and safety in the pediatric colorectal surgery population.Methods: Patients less than 21 years of age who underwent abdominal surgery and received a unilateral or bilateral QLB over a 4-year period were identified in the electronic medical record. Patient demographics, surgery type, and QLB characteristics were retrospectively examined. Pain scores and opioid consumption were tabulated over the first 72-h postoperative period. QLB procedural complications or adverse events attributable to the regional anesthetic were obtained. Results:The study cohort included 204 QLBs in 163 pediatric-aged patients (2 days to 19 years of age, median age of 2.4 years). The most common indication was unilateral blockade for ostomy creation or reversal. The majority of QLBs were performed using ropivacaine 0.2% with a median volume of 0.6 mL/kg. The median opioid requirement in oral morphine milligram equivalents (MMEs) was 0.7, 0.5, and 0.3 MME/kg on the first, second, and third postoperative days, respectively. Median pain scores were less than 2 over each time period. Aside from block failure (incidence 1.2%), there were no complications or postoperative adverse events related to the QLBs. Conclusion:This retrospective review in a large cohort of pediatric patients demonstrates that the QLB can be performed safely and efficiently in children undergoing colorectal surgery. The QLB provides adequate postoperative analgesia, has a high success rate, may limit postoperative opioid consumption, and is associated with a limited adverse effect profile.

show abstract

“…The TAP block added to combination of paracetamol and NSAID does not improve pain control compared to effects provided by combination of paracetamol and NSAID alone. 31,32 QLB significantly reduces perioperative opioid use after CD, 8,[22][23][24][26][27][28]33 laparoscopic hysterectomy (LH), [34][35][36] and total abdominal hysterectomy (TAH), 37,38 and consequently a frequency of postoperative nausea and vomiting. 35 QLB as a part of multimodal pain management, given in combination with paracetamol and NSAID, also prolongs time to first request for breakthrough pain following CD, 8,[22][23][24]27,33 LH, 34,35,39 and TAH.…”

Section: Discussionmentioning

confidence: 99%

“…35 QLB as a part of multimodal pain management, given in combination with paracetamol and NSAID, also prolongs time to first request for breakthrough pain following CD, 8,[22][23][24]27,33 LH, 34,35,39 and TAH. 38 QLB provides larger filed of analgesia and more lasting analgesia (up to 24-36 hours) compering to TAP block (up to 10 hours) after CD, 23,27,28,33 LH 34,39 and TAH, 37,38 decreasing a number of breakthrough pain requests. Having a skin injection point more lateral of surgical incision than TAP block, QLB minimizes a risk for surgical site contamination.…”

Section: Discussionmentioning

confidence: 99%

“…QLB significantly reduces perioperative opioid use after CD, ( 8 , 22 - 24 , 26 - 28 , 33 ) laparoscopic hysterectomy (LH), ( 34 - 36 )and total abdominal hysterectomy (TAH), ( 37 , 38 ) and consequently a frequency of postoperative nausea and vomiting. ( 35 ) QLB as a part of multimodal pain management, given in combination with paracetamol and NSAID, also prolongs time to first request for breakthrough pain following CD, ( 8 , 22 - 24 , 27 , 33 ) LH, ( 34 , 35 , 39 ) and TAH.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Interfascial Plane Blocks in Obstetric and Gynecologic Surgery

Pejčić¹

2022

ACC

View full text Add to dashboard Cite

Introduction: Interfascial plane blocks (IPB) are truncal blocks with local anesthetic injected into space between two muscle layers. IPBs are easy to learn, simple to perform, provide satisfactory analgesia up to 24 hours, having a minimal risk of complications.Methods: We present a retrospective analysis of the patients who had IPB as a part of postoperative pain management plan following either CD or hysterectomy in Leskovac General Hospital, Serbia during the period April 2017 -February 2022.Results: We had 131 patients who had IPB perioperatively. Bilateral QLB type 1 was performed in 53 patients after CD and in 68 patients after hysterectomy. Bilateral ESPB T10-11 was done following one CD case and in 9 patients before hysterectomy. Patients had both acetaminophen and nonsteroidal anti-inflammatory drug for postoperative pain control. Decreased usage of fentanyl and sevoflurane was noticed in the cases where IPB was performed preoperatively. Almost all patients had well-controlled pain, and were very satisfied with pain score of 0-4/10 at numeric rating scale during 24 hours after surgery, with no opioid use. There were no complications regarding block performance.Conclusion: QLB and ESPB have great potential to improve and facilitate postoperative pain management in obstetric and gynecologic surgery.

show abstract

Ultrasound Guided Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Post-operative Analgesia in Patients Undergoing Total Abdominal Hysterectomy

Cited by 13 publications

References 14 publications

A Comparative Study of Ultrasound-Guided Quadratus Lumborum Block and Transversus Abdominis Plane Block for Postoperative Analgesia Following Total Abdominal Hysterectomy

A Comparative Study of Ultrasound-Guided Quadratus Lumborum Block and Transversus Abdominis Plane Block for Postoperative Analgesia Following Total Abdominal Hysterectomy

Quadratus Lumborum Blockade for Postoperative Analgesia in Infants and Children Following Colorectal Surgery

Interfascial Plane Blocks in Obstetric and Gynecologic Surgery

Contact Info

Product

Resources

About