Ultrasound-guided anterior quadratus lumborum block at the L2 level for postsurgical analgesia in patients undergoing laparoscopic gynaecological surgery: a single-centre, randomised, double-blinded trial at a university-affiliated hospital in China

Huang, Lvdan; Cai, Yaoyao; Yang, Lili; Liu, Le; Wang, Quanguang; Shi, Kejian

doi:10.1136/bmjopen-2023-073917

Cited by 2 publications

(1 citation statement)

References 31 publications

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“…In group Q, after the target site was determined, 20 ml of 0.50% lidocaine (Hebei Tiancheng Pharmaceutical Co., Ltd; Approval number: H13022313; Specification: 5 ml:100 mg) and 0.20% ropivacaine (Shijiazhuang No.4 Pharmaceutical Co. Ltd.; Approval number: H20203107; Specification:10 ml:100 mg) diluted in NS was injected into each side 11 . In group C, 20 ml of NS was injected into each side, and the dermatomes of the sensory block at the 15th minute were evaluated using a pinprick for all subjects 12 , 13 .…”

Section: Methodsmentioning

confidence: 99%

Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial

Dai,

Li,

Weng

et al. 2024

Sci Rep

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In the past, quadratus lumborum block (QLB) was mostly used for postoperative analgesia in patients, and few anesthesiologists applied it during surgery with opioid-free anesthesia (OFA). Consequently, it is still unclear whether QLB in the supine position can provide perfect analgesia and inhibit anesthetic stress during surgery under the OFA strategy. To observe the clinical efficacy of ultrasound-guided quadratus lumborum block (US-QLB) in the supine position with OFA for lower abdominal and pelvic surgery. A total of 122 patients who underwent lower abdominal or pelvic surgery in People’s Hospital of Wanning between March 2021 and July 2022 were selected and divided into a quadratus lumborum block group (Q) (n = 62) and control group (C) (n = 60) according to the random number table method. Both groups underwent general anesthesia combined with QLB in the supine position. After sedation, unilateral or bilateral QLB was performed via the ultrasound guided anterior approach based on images resembling a “human eye” and “baby in a cradle” under local anesthesia according to the needs of the operative field. In group Q, 20 ml of 0.50% lidocaine and 0.20% ropivacaine diluted in normal saline (NS) were injected into each side. In group C, 20 ml of NS was injected into each side. The values of BP, HR, SPO2, SE, RE, SPI, NRS, Steward score, dosage of propofol, dexmedetomidine, and rocuronium, the number of patients who needed remifentanil, propofol, or diltiazem, puncture point, block plane, duration of anesthesia, catheter extraction, and wakefulness during the operation were monitored. There were no significant differences in the general data, number of cases requiring additional remifentanil, propofol, or diltiazem treatment, as well as puncture point and puncture plane between the two groups (P > 0.05). HR, SBP, and DBP values were higher in group Q than in group C at T1; HR, SPI, and SE, while RE values were lower in group Q than in group C at T3, SE, and RE; the Steward score was higher in group Q than in group C at T4 and T5, and the difference was statistically significant (P < 0.05). The extubation and awake times were lower in group Q than in group C, and the difference was statistically significant (P < 0.05). The SE, RE, and SPI values were lower at T1, T2, T3, and T4 than at T0. The Steward scores at T4 and T5 were higher in group Q than in group C, and were lower than at T0, with a statistically significant difference (P < 0.05). There were significant differences in the effectiveness of postoperative analgesia between the two groups at t1, t3 and t4 (P < 0.05). US-QLB in the supine position with OFA is effective in patients undergoing lower abdominal or pelvic surgery with stable intraoperative vital signs, complete recovery and better postoperative analgesia.

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Section: Methodsmentioning

confidence: 99%

Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial

Dai,

Li,

Weng

et al. 2024

Sci Rep

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Anterior quadratus lumborum blocks for postoperative pain treatment following intra‐abdominal surgery: A systematic review with meta‐analyses and trial sequential analyses

Tanggaard,

Gronlund,

Nielsen

et al. 2024

Acta Anaesthesiol Scand

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BackgroundThe anterior quadratus lumborum (QL) block may be used for postoperative pain management for intra‐abdominal surgeries, but the evidence is uncertain. We aimed to investigate the benefit and harm of the anterior QL block compared to placebo/no block for intra‐abdominal surgery.MethodsWe searched Medline, Embase, and CENTRAL for randomized controlled trials investigating anterior QL block for postoperative pain management for adult patients undergoing any intra‐abdominal surgery. The two co‐primary outcomes were cumulative 24‐h opioid consumption and serious adverse events. We performed meta‐analysis, trial sequential analysis (TSA), assessed the risk of bias, and present the certainty of evidence with the Grading of Recommendations, Assessment, Development and Evaluation approach.ResultsThirty‐five trials randomizing 2418 patients were included in the meta‐analyses. Anterior QL block may reduce cumulative 24‐h intravenous opioid consumption compared to placebo/no block (MD −10.42 mg, 96.7% CI −14.83 to −6.01, TSA‐adjusted CI −17.03 to −3.82, p < .01). Two trials reported on SAEs. Anterior QL block may have little to no effect on the number of serious adverse events compared to placebo (RR 1.49, 96.7% CI 0.19 to 11.47, p = .68), but the evidence is very uncertain. All trial results were assessed as being high risk of bias.ConclusionsThe anterior QL block may reduce cumulative 24‐h opioid consumption. Reported serious adverse events were few and the anterior QL block may have little to no effect on the number of SAEs, but the evidence was very uncertain.

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Ultrasound-guided anterior quadratus lumborum block at the L2 level for postsurgical analgesia in patients undergoing laparoscopic gynaecological surgery: a single-centre, randomised, double-blinded trial at a university-affiliated hospital in China

Cited by 2 publications

References 31 publications

Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial

Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial

Anterior quadratus lumborum blocks for postoperative pain treatment following intra‐abdominal surgery: A systematic review with meta‐analyses and trial sequential analyses

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