Ultrasound-guided quadratus lumborum block versus transversus abdominis plane block in patients undergoing total abdominal hysterectomy

Alansary, Amin Mohammed; Kamaly, Ayman M; Hamid, Hatem S Abdel; Aboelanean, Yassmin M.; Ezzat, Ahmed Wagih

doi:10.1186/s42077-022-00224-3

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…Consistent with our findings, Jadon et al [19] concluded For women having a caesarean section, QLB extends the duration of pain relief and reduces the need for supplementary analgesics in comparison to the TAP block. Similar to our finding, Alansary et al [20] determined that QLB administered after total abdominal hysterectomy (TAH) was more efficacious in alleviating visceral and somatic pain compared to TAP block. Based on the findings reported by Oksüz et al [21] , it was determined that the QLB offered more prolonged and efficacious postoperative analgesia in paediatrics receiving orchiopexy or unilateral surgery of an inguinal hernia when compared to the TAP block.…”

Section: Discussionsupporting

confidence: 91%

Comparative study of three different techniques for postoperative analgesia after abdominal hysterectomy

Elgohary,

Alshehdawy,

El-Shmaa

et al. 2023

Int. J. Med. Anesthesiology

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Background: Our hypothesis posited that the quadratus lumborum block (QLB) is superior to both local wound infiltration (LWI) and the transversus abdominis plane (TAP) block in reducing visual analogue scale (VAS) and overall morphine use. The aim of this study was to assess and contrast the pain-relieving effectiveness of ultrasound guided QLB, ultrasound guided TAP block, and LWI in female patients undergoing abdominal hysterectomy. Methods:The study was carried out on a sample of 105 female patients, ranging in age from 40 to 65 years, who had an ASA physical status of I or II. The participants were scheduled to have elective abdominal hysterectomy, and the trial was conducted using a prospective randomized, double-blinded design. The participants were allocated into 3 equal groups by a random process, with each group including 35 individuals. Group I: Ultrasound-guided QLB group. Group II: Ultrasound-guided TAP group. Group III: LWI group. Results: VAS showed a statistically significant difference among the 3 groups at 6, 12, and 24 hours (P value <0.001), while no significant difference occurred at 1, 2, and 4 hours among 3 groups. After 6 hours, the VAS scores were similar in group I and group II, but considerably lower in both groups compared to group III (p<0.001). After 12 hours, the VAS score was considerably lower in group I compared to group II and group III. Additionally, there was an increase in VAS score in group III when compared to group II (p<0.05). After 24 hours, a comparison among 3 groups revealed a drop in VAS in group I compared to the other two groups (p<0.05), although there was no significant difference between group II and group III. Conclusions: Ultrasound-guided QLB outperformed Ultrasound-guided TAP block and LWI in managing postoperative pain after abdominal hysterectomy. This superiority was shown in terms of pain score, total morphine use, duration of pain relief and time of first request for pain relief.

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Section: Discussionsupporting

confidence: 91%

Comparative study of three different techniques for postoperative analgesia after abdominal hysterectomy

Elgohary,

Alshehdawy,

El-Shmaa

et al. 2023

Int. J. Med. Anesthesiology

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“…This difference can be associated with a better spread of injection in SAM. [ 12 ] The results of our study are comparable to the study of El-Kabariety[ 13 ] which showed 100 mg tramadol used as an adjuvant with 20 ml of 0.5% levobupivacaine in transverse abdominis plane block had lesser morphine requirements in the first 48 h (18.1 ± 2.4 mg vs 26.1 ± 3.3 mg; P < 0.001) compared to levobupivacaine alone. However, the time to first morphine requirement was longer in our study group (6.11 ± 2.72 h vs 250.8 ± 23.3 min).…”

Section: Discussionsupporting

confidence: 85%

Role of tramadol as an adjuvant in ultrasound-guided serratus anterior muscle block for modified radical mastectomy - A randomized control trial

Singla,

Palta,

Saroa

et al. 2024

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: Modified radical mastectomy (MRM) is associated with significant acute post-operative pain that may progress to chronic pain syndromes in 25–60% of patients. Serratus anterior muscle (SAM) block has proved to be an excellent analgesic option in patients undergoing MRM. Although many adjuvants have been utilized for the prolongation of analgesia, the role of tramadol in SAM has not been studied as yet. We hypothesize that the addition of tramadol to ropivacaine for SAM block may reduce morphine consumption in the post-operative period in patients undergoing elective MRM surgeries. The primary aim of the study was to compare cumulative post-operative morphine consumption over 24 h in patients receiving SAM block with or without tramadol. The secondary aims were to observe adverse events related to the procedure or medications. The other parameters recorded were non-invasive blood pressure (NIBP), pulse rate, respiratory rate, and nausea or vomiting. Material and Methods: Patients scheduled to undergo MRM were randomly allocated by block randomization into two groups. The study group (Group T) received a SAM block with 0.25% ropivacaine (18 ml) with tramadol 100 mg while the control group (Group P) received a SAM block with 18 ml of 0.25% ropivacaine and 2 ml of saline. Patients were assessed for pain scores, analgesic requirement, time to first analgesic request, hemodynamic variables, and any side-effects at 30 min, 1 h, 4 h, 8 h, 12 h, and 24 h post-operatively. Results: Cumulative morphine consumption over 24 h in the post-operative period was less in the group T (3.06 ± 1.53 mg vs 4.34 ± 1.53 mg; P 0.001). Time to the first analgesic requirement was more in group T (10.44 ± 5.04 h vs 6.11 ± 2.73 h; P < 0.001). Pain scores were significantly lower in the group T at all time points. Conclusion: Tramadol, when used as an adjuvant to ropivacaine for SAM block reduces post-operative pain scores in the first 24 h and prolongs the time of first morphine requirement.

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“…The previous studies have demonstrated the effectiveness of QLB in different types of abdominal operations, including cesarean section [25], [26], laparoscopic gynecological surgery [27], total abdominal hysterectomy [28], and other abdominal surgeries [29], [30]. A meta-analysis showed that QLB provides better pain management with less opioid consumption after abdominal surgery compared with TAP block [31].…”

Section: Resultsmentioning

confidence: 99%

Perioperative Analgesic Efficiency of Ultrasound-Guided Quadratus Lumborum Block versus Epidural Analgesia in Bladder Cancer Patients Undergoing Radical Cystectomy

Bakeer

Abdelhamid

Nabil

et al. 2022

Open Access Maced J Med Sci

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Background and Aim: Multimodal analgesia is currently used for perioperative pain management after Radical cystectomy (RC). This study aimed to compare quadratus lumborum block (QLB) and thoracic epidural block (TEA) in patients subjected to RC. Methods: This prospective randomized controlled study included 34 patients with bladder cancer subjected to RC under general anesthesia, divided into two groups. The Quadratus Group (n=17) underwent bilateral ultrasound-guided continuous QLB, and the Epidural Group (n=17) underwent continuous TEA. The primary outcome was pain intensity measured by VAS score, and the secondary outcomes were total morphine consumption during the first 48 hours after surgery, postoperative nausea score, and patient satisfaction. Results: There were no differences between the two groups in postoperative VAS scores starting immediately after surgery up to 48 hours. Reduction of VAS score after QLB was delayed compared to that after TEA. The two groups had a comparable number of patients requesting rescue analgesia (p = 0.271) and total postoperative morphine consumption (p = 0.976) in the remaining patients. The nausea score was significantly lower in the Quadratus Group than in the Epidural Group (p = 0.020). There was no significant difference between the two groups in the satisfaction score (p=0.612). Few mild complications were detected in the two studied groups. Conclusion: QLB and TEA are safe and effective in managing postoperative pain after radical cystectomy with similar analgesic profiles. QLB was more effective in reducing postoperative nausea and vomiting.

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Ultrasound-guided quadratus lumborum block versus transversus abdominis plane block in patients undergoing total abdominal hysterectomy

Cited by 8 publications

References 17 publications

Comparative study of three different techniques for postoperative analgesia after abdominal hysterectomy

Comparative study of three different techniques for postoperative analgesia after abdominal hysterectomy

Role of tramadol as an adjuvant in ultrasound-guided serratus anterior muscle block for modified radical mastectomy - A randomized control trial

Perioperative Analgesic Efficiency of Ultrasound-Guided Quadratus Lumborum Block versus Epidural Analgesia in Bladder Cancer Patients Undergoing Radical Cystectomy

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