Ultrasound-Guided Quadratus Lumborum Block Combined with General Anaesthesia or General Anaesthesia Alone for Laparoscopic Radical Gastrectomy for Gastric Adenocarcinoma: A Monocentric Retrospective Study

Ran Jiao; Shuai Peng; Lulu Wang; Man Feng; Youqin Li; Jing Sun; Dongyi Liu; Jia Fu; Chang Feng

doi:10.2147/IJGM.S382757

Ultrasound-Guided Quadratus Lumborum Block Combined with General Anaesthesia or General Anaesthesia Alone for Laparoscopic Radical Gastrectomy for Gastric Adenocarcinoma: A Monocentric Retrospective Study

Int J Gen Med. 2022 Oct 10:15:7739-7750. doi: 10.2147/IJGM.S382757. eCollection 2022.

Authors

Ran Jiao¹, Shuai Peng², Lulu Wang³, Man Feng⁴, Youqin Li³, Jing Sun³, Dongyi Liu⁵, Jia Fu⁵, Chang Feng⁵

Affiliations

¹ Hospital of Shandong University, Jinan, 250100, People's Republic of China.
² Department of Nursing, Yankuang New Journey General Hospital, Zoucheng, 273500, People's Republic of China.
³ Cheeloo College of Medicine, Shandong University, Jinan, 250102, People's Republic of China.
⁴ Department of Pathology, Affiliated Hospital of Shandong Academy of Medical Sciences, the Third Affiliated of Shandong First Medical University, Jinan, 250000, People's Republic of China.
⁵ Department of Anaesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, People's Republic of China.

Abstract

Purpose: To investigate, in patients with gastric carcinoma undergoing laparoscopic radical gastrectomy, the effects of ultrasound-guided quadratus lumborum block (UG-QLB) combined with general anaesthesia (GA) on the postoperative recovery compared with GA alone.

Patients and methods: The retrospective study enrolled 231 patients with gastric carcinoma undergoing laparoscopic radical gastrectomy, including 119 patients who received UG-QLB combined with GA (Group QG), and 112 patients undergoing GA alone (Group GA). The primary endpoint was the postoperative 3-year recurrence-free survival (RFS). The secondary endpoints were the average visual analogue scale (VAS) scores within 48 h after surgery, the first time of postoperative ambulation, the first time of flatus, postoperative hospitalization, perioperative opioid requirement and adverse effects after surgery.

Results: UG-QLB combined with GA did not affect the 3-year RFS in patients undergoing laparoscopic radical gastrectomy (HR 0.659, 95% CI 0.342-1.269, P=0.212). However, the VAS ranking analysis implicated that it could significantly alleviate the postoperative pain in laparoscopic radical gastrectomy patients (P<0.01). In addition, it dramatically facilitated the early recovery of postoperative ambulation and flatus, while shortening the duration of postoperative hospitalization (P<0.01). The most important was it could remarkably reduce the opioid consumption (P<0.01), which in the meanwhile, reduced the incidence of postoperative nausea and vomiting (PONV) (P=0.01).

Conclusion: Although UG-QLB combined with GA did not improve the 3-year RFS for patients with gastric carcinoma undergoing laparoscopic radical gastrectomy, it could provide satisfactory postoperative pain relief, reduce opioid consumption and adverse effects, which subsequently facilitates postoperative early rehabilitation.

Keywords: gastric adenocarcinoma; laparoscopic radical gastrectomy; postoperative early recovery; prognosis; quadratus lumborum block; ultrasound guidance.

Grants and funding

This work was supported by the scientific research fund of Shandong Medical Association under Grant No. YXH2020ZX021. This study was also supported by clinical medicine science and technology innovation plan of Jinan Science and Technology Bureau, Shandong Province, China (No. 202019127). Additionally, this study was supported by National health commission of China Key R&D Program(No. GWJJ2022100301-2.