Quadratus Lumborum Blocks in Nephrectomy: A Narrative Review

Little, Christopher; Rahman, Siamak

doi:10.2147/lra.s290224

Cited by 17 publications

(10 citation statements)

References 45 publications

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“…However, the Epidural group had significatively fewer rescue analgesics than QLB. This result is contrary to a human study [ 21 ] in which patients receiving quadratus lumborum block for nephrectomies had reduced opioid requirements, reduced pain scores, and improved side effects relative to other analgesic modalities such as epidurals.…”

Section: Discussioncontrasting

confidence: 97%

Clinical Assessment of Introducing Locoregional Anaesthesia Techniques as Part as the Intraoperative Analgesia Management for Canine Ovariohysterectomy in a Veterinary Teaching Hospital

Viscasillas

Cañón

Hernández

et al. 2022

Animals

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This study compared four methods to provide intraoperative analgesia during canine ovariohysterectomy in a veterinary teaching hospital. A retrospective study was designed to assess the nociceptive response, cardiorespiratory stability, quality of recovery and complications of four analgesic protocols: epidural analgesia (EPIDURAL group), Quadratus Lumborum block (QLB group), Transversus Abdominis Plane block (TAP group), and just systemic analgesia (GENERAL group). Undergraduate students carried out all the loco-regional techniques under the direct supervision of a qualified anaesthetist. A total of 120 cases met the inclusion criteria and were included in the study and were distributed as follows: 22, 27, 32 and 39 cases with EPIDURAL, GENERAL, QLB and TAP groups, respectively. Data were analysed with statistical software R using different statistical methods. Significant differences among groups were defined as p < 0.05. Based on our results, all the groups needed the same number of rescue analgesia during the intra-operative period. The use of loco-regional techniques anticipated a better quality of recovery compared with the general group. The EPIDURAL group showed a statistically lower expired fraction of sevoflurane. No differences were found regarding complications. In conclusion, these four analgesic methods are suitable and safe to be performed for canine ovariohysterectomy, although loco-regional techniques might have some advantages.

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Section: Discussioncontrasting

confidence: 97%

Clinical Assessment of Introducing Locoregional Anaesthesia Techniques as Part as the Intraoperative Analgesia Management for Canine Ovariohysterectomy in a Veterinary Teaching Hospital

Viscasillas

Cañón

Hernández

et al. 2022

Animals

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“…They concluded that QLB significantly reduced postoperative opioid consumption by 43% and significantly prolonged time to rescue opioid therapy. Another important narrative review of QLB in open nephrectomy was consistent with reduced opioid consumption postoperatively (7) .…”

Section: Discussionmentioning

confidence: 97%

Evaluation of the Preemptive Analgesic Efficacy of Ultrasound Guided Quadratus Lumborum Block in Nephrectomy

Shehata

Youssef

kway

et al. 2022

Ain Shams Medical Journal

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Background: Nephrectomy is a particularly painful procedure especially the open type rather than the laparoscopic type. There are multiple techniques for postoperative pain management after nephrectomy; opioid therapy, neuraxial analgesia and Quadratus lumborum block.Aim of the study: to evaluate the preemptive analgesic efficacy of ultrasound guided lateral quadratus lumborum block during the intraoperative period of nephrectomy regarding opioids sparing effect and at the early postoperative period regarding pain relief, early mobilization and opioids sparing effect. Patients and Methods:This study included forty patients aging 18-65 years old, admitted to operating room in Ain Shams University hospitals for elective open and simple nephrectomy. The patients were divided into two equal groups, Group 1: The patients received general anesthesia with conventional pain management by intravenous opioids, Group 2: received preoperative unilateral ultrasound guided quadratus lumborum block using 0.4 ml/kg bupivacaine 0.25% combined with general anesthesia. Results:The current study showed significant decrease of the opioid consumption in the patients of the quadratus lumborum block group in both the intraoperative and postoperative periods with less pain score compared to the patients of the opioid group. Conclusion:Our results showed that the ultrasound guided quadratus lumborum block was an effective technique in providing preemptive analgesia in patients undergoing nephrectomy surgery. The patients who received QLB required less intraoperative and postoperative analgesic requirements, as well as postoperative rescue analgesia.

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“…[11] Recently, in addition to TAP block, quadratus lumborum block, retrolaminar block, and erector spinae plane block have been found to be useful in patients undergoing laparoscopic nephrectomy. [30–33]…”

Section: Discussionmentioning

confidence: 99%

Effect of transversus abdominis plane block on the quality of recovery in laparoscopic nephrectomy: A prospective double-blinded randomized controlled clinical trial

Park

Lee

2022

Medicine

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Background: Poorly controlled acute postoperative pain after laparoscopic nephrectomy may adversely affect surgical outcomes and increase morbidity rates. In addition, excessive use of opioids during surgery may slow postoperative endocrine and metabolic responses and cause opioid-related side effects and opioid-induced hyperalgesia. The purpose of this study was to evaluate the effect of ultrasound-guided transversus abdominis plane (TAP) block on the postoperative quality of recovery and intraoperative remifentanil requirement in laparoscopic nephrectomy. Methods: Sixty patients who underwent laparoscopic nephrectomy were randomly divided into 2 groups: TAP and Control groups. After induction of anesthesia and before awakening from anesthesia, the TAP group was administered 40 mL of 0.375% ropivacaine and the Control group was administered 40 mL of normal saline to deliver ultrasound-guided TAP block using 20 mL of each of the above drugs. The main objectives of this study were to evaluate the effect of the TAP block on quality of recovery using the Quality of Recovery 40 (QoR-40) questionnaire and assessments of intraoperative remifentanil requirement. In addition, to evaluate the postoperative analgesic effect of the TAP block, the total usage time for patient-controlled analgesia (PCA) and the number of PCA bolus buttons used in both groups were analyzed. Results: The QoR-40 score, measured when visiting the ward on the third day after surgery, was significantly higher in the TAP group (171.9 ± 23.1) than in the Control group (151.9 ± 28.1) ( P = .006). The intraoperative remifentanil requirement was not significantly different between the groups ( P = .439). In the TAP group, the frequency of bolus dose accumulation at 1, 2, 3, 6, 12, 24, 48, and 72 hours after surgery was low enough to show a significant difference, and the total usage time for PCA was long enough to show a significant difference. Conclusion: In conclusion, we determined that ultrasound-guided TAP block during laparoscopic nephrectomy improves the quality of postoperative recovery and is effective for postoperative pain control but does not affect the amount of remifentanil required for adequate anesthesia during surgery.

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Quadratus Lumborum Blocks in Nephrectomy: A Narrative Review

Cited by 17 publications

References 45 publications

Clinical Assessment of Introducing Locoregional Anaesthesia Techniques as Part as the Intraoperative Analgesia Management for Canine Ovariohysterectomy in a Veterinary Teaching Hospital

Clinical Assessment of Introducing Locoregional Anaesthesia Techniques as Part as the Intraoperative Analgesia Management for Canine Ovariohysterectomy in a Veterinary Teaching Hospital

Evaluation of the Preemptive Analgesic Efficacy of Ultrasound Guided Quadratus Lumborum Block in Nephrectomy

Effect of transversus abdominis plane block on the quality of recovery in laparoscopic nephrectomy: A prospective double-blinded randomized controlled clinical trial

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