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

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 24h 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 24h of post-op nausea vomiting (PONV) versus control (PONV; 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.