Quadratus Lumborum Block versus Transversus Abdominis Plane Block for Laparoscopic Radical Resection for Rectal Cancer

Abstract

Background: Both transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) can provide effective analgesia for abdominal surgery. Objectives: To explore whether there are differences in the effects of TAPB and QLB on the quality of postoperative recovery in patients undergoing laparoscopic radical resection for rectal cancer. Methods: In total, 102 patients undergoing laparoscopic radical resection for rectal cancer were randomly divided into two groups. Bilateral TAPB or QLB was performed using 0.375% ropivacaine after the induction of anesthesia. The 15-item Quality of Recovery (QoR-15) scale was used to assess the quality of recovery at 24 h postoperatively. Secondary indicators included 24-h postoperative fentanyl consumption, patient-controlled analgesia (PCA), incidence of adverse reactions, numerical rating scale (NRS) at rest and during exercise, and incidence of postoperative complications. Results: QoR-15 scores were higher in the QLB group than in the TAPB group (115.6±11.3 vs. 99.7±14.2, P<0.05). Moreover, the 24-h sufentanil consumption was less in the QLB group than in the TAPB group (2.4±0.5 vs. 5.5±0.3 μg, P<0.05) after surgery. Time durations to first postoperative PCA compression were 152.1±28.4 and 100.3 ± 22.9 min, respectively (P<0.05). The numbers of PCA compressions within 24 h after surgery were 6.0 (2.0, 8.0) and 9.0 (3.0, 12.0) (P<0.05). There were no differences in secondary outcomes, such as adverse reactions, NRS scores at rest and exercise at 24 h postoperatively, as well as complication rates. Conclusion: Patients undergoing laparoscopic radical resection for rectal cancer with QLB had a better quality of recovery and better analgesic effects at 24 h postoperatively, compared to TAPB