Quadratus lumborum block versus transversus abdominis plane block for postoperative pain management after laparoscopic colorectal surgery: A randomized controlled trial

Medicine (Baltimore). 2019 Dec;98(52):e18448. doi: 10.1097/MD.0000000000018448.

Abstract

Background: This study aimed to compare the quadratus lumborum block (QLB) method with transversus abdominis plane block (TAPB) for postoperative pain management in patients undergoing laparoscopic colorectal surgery.

Methods: Seventy-four patients scheduled for laparoscopic colorectal surgery were randomly assigned into 2 groups. After surgery, patients received bilateral ultrasound-guided single-dose of QLB or TAPB. Each side was administered with 20 ml of 0.375% ropivacaine. All patients received sufentanil as patient-controlled intravenous analgesia (PCIA). Resting and moving numeric rating scale (NRS) were assessed at 2, 4, 6, 24, 48 hours postoperatively. The primary outcome measure was sufentanil consumption at predetermined time intervals after surgery.

Results: Patients in the QLB group used significantly less sufentanil than TAPB group at 24 and 48 hours (P < .05), but not at 6 hours (P = .33) after laparoscopic colorectal surgery. No significant differences in NRS results were found between the two groups at rest or during movement (P > .05). Incidence of dizziness in the QLB group was lower than in TAPB group (P < .05).

Conclusions: The QLB is a more effective postoperative analgesia as it reduces sufentanil consumption compared to TAPB in patients undergoing laparoscopic colorectal surgery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abdominal Muscles / innervation*
  • Abdominal Oblique Muscles / innervation*
  • Anesthetics, Local / administration & dosage
  • Colorectal Neoplasms / surgery
  • Colorectal Surgery / methods*
  • Female
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain Management / methods
  • Pain, Postoperative / therapy*
  • Ropivacaine / administration & dosage
  • Sufentanil / administration & dosage
  • Ultrasonography, Interventional

Substances

  • Anesthetics, Local
  • Ropivacaine
  • Sufentanil