Ultrasound guided lateral quadratus lumborum block enhanced recovery in patients undergoing laparoscopic colorectal surgery

Adv Med Sci. 2021 Mar;66(1):41-45. doi: 10.1016/j.advms.2020.12.002. Epub 2020 Dec 22.

Abstract

Purpose: This study aimed to evaluate the effects of lateral quadratus lumborum block (QLB) on postoperative pain and recovery in patients undergoing laparoscopic colorectal surgery.

Materials and methods: Patients between 18 and 70 years old, diagnosed with colon or rectal cancer, with American Society of Anesthesiologists (ASA) physical status I or II, and scheduled for laparoscopic colorectal surgery were recruited. Patients were excluded if they were allergic to local anesthetics and unable to complete the procedure of puncture or follow-up evaluation. All included patients were randomly allocated to either QLB or Sham group. The primary outcome was perioperative cumulative sufentanil consumption.

Results: There were no significant differences between the groups in anesthetic time, operation time, dosage of propofol, and remifentanil (P ​> ​0.05). Patients in the QLB group had significantly less sufentanil consumption both intraoperatively and postoperatively, compared with the Sham group (P ​< ​0.05). Postoperative VAS pain scores on coughing in the QLB group at 2 ​h, 6 ​h, 12 ​h, 24 ​h time points and VAS pain score at rest 2 ​h, 6 ​h after surgery were significantly lower than in the Sham group (P ​< ​0.05). Compared with the Sham group, time to first ambulation and anal flatus after surgery in the QLB group were significantly shorter (P ​< ​0.05). Significant differences of postoperative rescue analgesic usage and QoR-15 score at 48 ​h were found between the two groups (P ​< ​0.05).

Conclusions: Ultrasound-guided lateral QLB significantly reduced perioperative opioid consumption, alleviated postoperative pain, shortened the time to first ambulation and anal flatus, and enhanced postoperative recovery of the patients undergoing laparoscopic colorectal surgery.

Keywords: Colorectal surgery; Laparoscopy; Postoperative analgesia; Quadratus lumborum block.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthetics, Local / administration & dosage*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Colorectal Surgery / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy / adverse effects*
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain, Postoperative / diagnostic imaging
  • Pain, Postoperative / etiology
  • Pain, Postoperative / pathology
  • Pain, Postoperative / prevention & control*
  • Prognosis
  • Ultrasonography / methods*
  • Young Adult

Substances

  • Anesthetics, Local