Ultrasound-Guided Transmuscular Quadratus Lumbar Block Reduces Opioid Consumption after Laparoscopic Partial Nephrectomy

Cui, Xu; Li, Xu; Li, Min Na; Zhang, Yue Lun; Xie, Yi; Yan, Wei; Zhang, Yu Shi; Ji, Zhi Gang; Huang, Yuguang

doi:10.24920/003759

Cited by 12 publications

(5 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…8,14,15 Similarly, urologic and general surgery data largely support the use of QL blocks for intraabdominal surgery, demonstrating earlier time to ambulation, decreased postoperative nausea and vomiting, and decreased postoperative opioid use and pain scores. [9][10][11][12][13][16][17][18] Despite the demonstrated benefits of the QL block in abdominal-based surgery, literature exploring the use of the QL block in plastic surgery currently lags behind that of other specialties. To date, only two RCTs and one case report evaluate the use of the QL block in plastic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Although the transversus abdominal plane (TAP) block remains one of the most widely used regional blocks in abdominal surgery ERAS pathways, studies have recently begun to explore the efficacy of the quadratus lumborum (QL) block in abdominal procedures in obstetrics and gynecologic, urology, and general surgery. [7][8][9][10][11][12][13][14][15][16][17][18] The QL block has been hypothesized as an effective alternative to the TAP block in abdominalbased breast reconstruction, with some studies finding improved pain control with the QL block. 19,20 Yet, no consensus has been reached regarding the superiority of either block.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

New Kid on the Block: A Systematic Review of the Quadratus Lumborum Block in Plastic and Reconstructive Surgery

Ihnat,

Evans,

Zhao

et al. 2024

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Although the transversus abdominal plane (TAP) block is commonly used in abdominal surgery as part of enhanced recovery after surgery pathways, the quadratus lumborum (QL) block has been hypothesized as an effective alternative to the TAP block in some areas. This review evaluates the current literature, as it relates to the QL block in plastic and reconstructive surgery. Methods: A systematic review using PubMed searched for all original, peer-reviewed articles, including the term “quadratus lumborum block.” In total, 509 articles were identified for review by two independent reviewers. Original articles evaluating the use of a QL block in any plastic surgery operation were included. Articles evaluating pediatric patients, animal trials, and the use of a QL block in any nonplastic surgery operation were excluded. Results: Three articles met inclusion criteria. One trial demonstrated decreased subjective pain scores and total opioid use, whereas the second found no statistically significant difference. A case study described the use of a QL block for unilateral breast reconstruction with minimal opiate use and reduced pain scores postoperatively. Limitations include the limited number of studies and the heterogeneity in study type and design, making analysis difficult. Conclusions: Despite its demonstrated efficacy in other surgical subspecialties, there are limited data evaluating the use of the QL block in plastic and reconstructive surgery. Additional research is needed to evaluate the role of the QL block in plastic surgery and how it compares to the more widely utilized TAP block.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

New Kid on the Block: A Systematic Review of the Quadratus Lumborum Block in Plastic and Reconstructive Surgery

Ihnat,

Evans,

Zhao

et al. 2024

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge, no prospective clinical trials have compared the analgesic efects of single-shot TMQLB and TPVB. Both TMQLB and TPVB have been reported to be efective analgesic modalities for laparoscopic urological surgeries [7][8][9][10][11][12]. Compared to TPVB, TMQLB avoids the risk of pneumothorax and has lower coagulation requirements.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Postoperative Analgesic Effects between Ultrasound-Guided Transmuscular Quadratus Lumborum Block and Thoracic Paravertebral Block in Laparoscopic Partial Nephrectomy Patients: A Randomized, Controlled, and Noninferiority Study

Wang

Cui

Ren

et al. 2023

Pain Research and Management

View full text Add to dashboard Cite

Background. This prospective, randomized, double-blinded, noninferiority study aimed to compare the effects of analgesia and recovery between transmuscular quadratus lumborum block (TMQLB) and paravertebral block (PVB). Methods. Sixty-eight, American Society of Anesthesiologists level I–III patients, who underwent laparoscopic partial nephrectomy in Peking Union Medical College Hospital were randomly allocated to either TMQLB or PVB group (independent variable) in a 1 : 1 ratio. The TMQLB and PVB groups received corresponding regional anesthesia preoperatively with 0.4 ml/kg of 0.5% ropivacaine and follow-up at postoperative 4, 12, 24, and 48 hours. The participants and outcome assessors were blinded to group allocation. We hypothesized that the primary outcome, postoperative 48-hour cumulative morphine consumption, in the TMQLB group was not more than 50% of that in the PVB group. Secondary outcomes including pain numerical rating scales (NRS) and postoperative recovery data were dependent variables. Results. Thirty patients in each group completed the study. The postoperative 48-hour cumulative morphine consumption was 10.60 ± 5.28 mg in the TMQLB group and 6.40 ± 3.40 mg in the PVB group. The ratio (TMQLB versus PVB) of postoperative 48-hour morphine consumption was 1.29 (95% CI: 1.13–1.48), indicating a noninferior analgesic effect of TMQLB to PVB. The sensory block range was wider in the TMQLB group than in the PVB group (difference 2 dermatomes, 95% CI 1 to 4 dermatomes, P = 0.004 ). The intraoperative analgesic dose was higher in the TMQLB group than in the PVB group (difference 32 µg, 95% CI: 3–62 µg, P = 0.03 ). The postoperative pain NRS at rest and on movement, incidences of side effects, anesthesia-related satisfaction, and quality of recovery scores were similar between the two groups (all P > 0.05 ). Conclusions. The postoperative 48-hour analgesic effect of TMQLB was noninferior to that of PVB in laparoscopic partial nephrectomy. This trial is registered with NCT03975296

show abstract

“…Quadratus lumborum block (QLB), as a recently discovered truncal regional block technique, can effectively reduce postoperative pain and opioid consumption for total hip arthroplasty [ 9 , 10 ], inguinal hernia repair [ 11 , 12 ], cholecystectomy [ 13 , 14 ], caesarean section [ 8 , 15 ], gynecologic surgery [ 16 ], percutaneous nephrolithotomy [ 17 ], nephrectomy [ 18 , 19 ], and colorectal surgery [ 20 , 21 ]. Furthermore, QLB improves the postoperative QoR in total hip arthroplasty [ 22 ] and laparoscopic partial nephrectomy [ 23 ]. The QoR is an index of the health status of patients after surgery, which includes five dimensions of health, namely, physical comfort, physical independence, psychological support, emotional status, and pain.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Quadratus Lumborum Block Enhances the Quality of Recovery after Gastrointestinal Surgery: A Randomized Controlled Trial

Liu

Dai

Xie

et al. 2022

Pain Research and Management

View full text Add to dashboard Cite

Background. Quadratus lumborum block (QLB) has been used to reduce postoperative acute pain and opioid consumption. However, the efficacy of QLB on the quality of recovery (QoR) after gastrointestinal surgery has not been established. The aim of this study was to evaluate the ability of QLB to enhance the postoperative QoR in patients undergoing open gastrointestinal surgery. Methods. Eighty-four patients undergoing open gastrointestinal surgery were randomized to receive ultrasound-guided QLB with either 20 ml of 0.375% ropivacaine or saline. The primary outcome was the QoR-15 score at 24 h after surgery. The secondary outcomes were the postoperative pain intensity, opioid consumption, the incidence of nausea, vomiting, and chronic pain. Results. The global QoR-15 score at 24 h postoperatively was significantly higher in the QLB group than in the control group (mean difference: 16.9; 95% CI: 11.9–21.9). Additionally, the QoR-15 scores for five dimensions were significantly higher in the QLB group than in the control group. The cumulative oxycodone consumption was significantly lower in the QLB group during 0–6, 6–24, 0–24, 24–48, and 0–48 h postoperatively than in the control group. At rest or during coughing, the pain verbal rating scale scores were significantly lower at 1, 3, 6, 12, and 24 h after surgery in the QLB group than in the control group. The incidence of postoperative nausea was significantly different between the groups, but postoperative vomiting was not. Conclusion. Single-injection posteromedial QLB with ropivacaine enhanced the QoR at 48 h after surgery and improved analgesia during the early postoperative period in patients undergoing gastrointestinal surgery.

show abstract

Ultrasound-Guided Transmuscular Quadratus Lumbar Block Reduces Opioid Consumption after Laparoscopic Partial Nephrectomy

Cited by 12 publications

References 32 publications

New Kid on the Block: A Systematic Review of the Quadratus Lumborum Block in Plastic and Reconstructive Surgery

New Kid on the Block: A Systematic Review of the Quadratus Lumborum Block in Plastic and Reconstructive Surgery

Comparison of the Postoperative Analgesic Effects between Ultrasound-Guided Transmuscular Quadratus Lumborum Block and Thoracic Paravertebral Block in Laparoscopic Partial Nephrectomy Patients: A Randomized, Controlled, and Noninferiority Study

Ultrasound-Guided Quadratus Lumborum Block Enhances the Quality of Recovery after Gastrointestinal Surgery: A Randomized Controlled Trial

Contact Info

Product

Resources

About