Quadratus lumborum block and transversus abdominis plane block in laparoscopic nephrectomy: a meta-analysis

Pain Manag. 2023 Sep;13(9):555-567. doi: 10.2217/pmt-2023-0033. Epub 2023 Sep 18.

Abstract

Aim: To study the efficacy of quadratus lumborum block (QLB) and transversus abdominis plane (TAP) in laparoscopic nephrectomy patients. Materials & methods: We conducted a meta-analysis of randomized controlled trials for QLB and/or TAP technique compared with each other or a control. Results: Direct analysis of 24 h post-op pain score at rest for each compared with control showed significant reduction, QLB (mean differences [MD] [95% CI]: -1.12 [-1.87,-0.36]; p = 0.004) and TAP (MD [95% CI]: -0.36 [-0.59, -0.12]; p = 0.003). With movement both were respectively lower than control QLB (MD [95% CI]: -1.12 [-1.51, -0.72]; p = <0.0001) and TAP (MD [95% CI]: -0.50 [-0.95, -0.05]; p = 0.03). Moreover, QLB demonstrated less risk 24 h of post-op nausea vomiting (PONV) versus control (PONV; risk ratios [RR] [95% CI]: 0.64 [0.45,0.90]; p = 0.01). Conclusion: TAP and QLB reduce pain scores compared with control, whereas only QLB reduces PONV compared with control.

Keywords: laparoscopic nephrectomy; quadratus lumborum; regional anesthesia; transversus abdominis plane block.

Publication types

  • Meta-Analysis

MeSH terms

  • Abdominal Muscles
  • Analgesics, Opioid
  • Anesthetics, Local
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Nephrectomy / adverse effects
  • Nerve Block* / methods
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control
  • Postoperative Nausea and Vomiting

Substances

  • Analgesics, Opioid
  • Anesthetics, Local