Perioperative analgesia with ultrasound-guided quadratus lumborum block for transurethral resection of prostate

Medicine (Baltimore). 2021 Dec 23;100(51):e28384. doi: 10.1097/MD.0000000000028384.

Abstract

Background: Prostatic hyperplasia is a physiological aging process in men. After transurethral resection of prostate (TURP), visceral pain is the main cause. The effective postoperative analgesia can reduce the occurrence of postoperative complications. This study mainly studied the analgesic effect of quadratus lumborum block (QLB) on TURP.

Methods: We divided 62 patients undergoing TURP into 2 groups using a random number table method (QLB 2 group and non-QLB [control] group). Patients in the QLB group underwent ultrasound-guided posterior QLB with 20 mL of 0.25% ropivacaine on each side, and those in the control group received only general anesthesia. The primary outcome for this study was the consumption analgesic pump during 0 to 24 hours. The secondary outcomes included the first pressing time of analgesic pump during 0 to 24 hours, the pain at rest and when coughing at 1, 4, 8, 12, and 24 hours post-operation as measured with a visual analogue scale for pain, length of the hospital stay, and complications (nausea and vomiting, dizziness, and abdominal distension).

Results: Patients in the QLB group presented less consumption, later first pressing time of analgesic pump during 0 to 24 hours after surgery lower visual analogue scale scores at 1, 4, 8, 12, and 24 hours postsurgery than those in the control group. Moreover, their mean length of hospital stay was shorter (P = .023), and they experienced less postoperative complications than the patients in the control group.

Conclusions: Ultrasound-guided QLB in TURP provided a significant analgesic effect in our patients the first day after surgery. This analgesic model may improve the postoperative recovery after TURP.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Abdominal Muscles*
  • Aged
  • Aged, 80 and over
  • Analgesia*
  • Anesthetics, Local
  • Humans
  • Male
  • Middle Aged
  • Nerve Block* / adverse effects
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control*
  • Prospective Studies
  • Transurethral Resection of Prostate / adverse effects*
  • Ultrasonography, Interventional

Substances

  • Anesthetics, Local