Quadratus Lumborum Block For Analgesia Research Articles

Anterior quadratus lumborum block for analgesia after living-donor renal transplantation: a double-blinded randomized controlled trial

IntroductionLimited non-opioid analgesic options are available for managing postoperative pain after renal transplantation. We aimed to investigate whether the unilateral anterior quadratus lumborum (QL) block would reduce postoperative opioid consumption...

The minimum effective concentration (MEC90) of ropivacaine for ultrasound-guided quadratus lumborum block for analgesia after cesarean delivery: a dose finding study

BackgroundQuadratus lumborum block was recently proposed as an alternative technique for post-cesarean delivery analgesia. However, there is not a definite optimum concentration of local anesthetics. A biased coin design up-and-down method was used to explore the minimum effective concentration of ropivacaine in quadratus lumborum block for satisfactory analgesia after cesarean delivery.MethodsFifty-six patients weighing 60–80 kg after cesarean section and with ages between 18 and 40 years were recruited. For the posterior quadratus lumborum block, a volume of 25 ml of the assigned concentration of ropivacaine was injected bilaterally.The concentration administered to each patient depended on the response to the previous dose. The first patient received 0.25%. If a successful block was observed, the next patient was randomized to receive the same ropivacaine concentration (with a probability of 0.89) or 0.025% less (with a probability of 0.11). After any block failure, the concentration was always increased by 0.025% for the next. The study ended when 45 successful blocks were obtained.We defined effective quadratus lumborum block as a resting visual analog score ≤ 3 and the absence of a need for rescue anesthetics.ResultsThe 90% minimum effective concentration of ropivacaine was 0.335% (95% CI 0.306 to 0.375%), and the 99% minimum effective concentration was 0.371% (95% CI 0.355 to 0.375%). The sufentanil consumption was 11 (11,13) and 24 (22,27) μg at 12 and 24 hours after quadratus lumborum block, respectively.ConclusionsThe optimum dosage of ropivacaine is a 25 ml volume of 0.335% for quadratus lumborum block after cesarean delivery.Trial registrationThe study was registered in the Chinese Clinical Trial Registry (No. ChiCTR2000040415).

Quadratus Lumborum Block for Analgesia after Cesarean Section with Spinal Anesthesia: A Randomized Controlled Study

Quadratus Lumborum Block for Analgesia after Cesarean Section with Spinal Anesthesia: A Randomized Controlled Study

Efficacy of quadratus lumborum block for analgesia in adult participants undergoing hip surgery: A meta-analysis of randomized controlled trials

Study objectiveThis study aimed to identify the benefits of quadratus lumborum block (QLB) in terms of postoperative analgesic effects in adult participants undergoing hip surgery. DesignMeta-analysis of randomized controlled trials. SettingPrevious randomized controlled trials that evaluated the analgesic effect of QLB compared to that of no block. PatientsNine studies including 616 participants. InterventionsParticipants in the treatment group received QLB, whereas those in the control group received no block. MeasurementsOutcomes were postoperative 24-h opioid consumption (primary), 12-h/24-h visual analog scale (VAS) or numeric rating scale (NRS) pain scores, postoperative nausea and vomiting (PONV), and satisfaction. The effect size was estimated using the standardized mean difference (SMD), mean difference (MD), or risk ratio (RR) with a 95% confidence interval (CI). We used the risk of bias tool (RoB 2) to assess the risk of bias of the included studies and the GRADE approach to determine the level of certainty of the evidence. Main resultsCompared to no block, the QLB group has less opioid consumption (SMD -1.69, 95% CI -2.54 to ‐0.84; low level of certainty of the evidence). Estimated MD for morphine consumption was 24 mg. The QLB group had a lower 12-h VAS/NRS pain score (MD -1.16, 95% CI -1.82 to ‐0.51; moderate level of certainty of the evidence) and 24-h VAS/NRS pain score (MD -0.92, 95% CI -1.42 to ‐0.43; moderate level of certainty of the evidence). QLB decreased the incidence of PONV (RR 0.43, 95% CI 0.24 to 0.79; moderate level of certainty of the evidence) and increased participants' satisfaction (SMD 1.15, 95% CI 0.63 to 1.67; moderate level of certainty of the evidence). Estimated MD for satisfaction was 1.74 points of Likert scale. There were no significant adverse events associated with the QLB in any of the included trials. ConclusionOur meta-analysis showed that QLB when compared to no block clinically decreased opioid requirements, reduced PONV, and improved participants' satisfaction. QLB also seems to be significantly superior to no block in terms of pain score, but its clinical importance remains unclear.

Quadratus Lumborum Block for Analgesia After Cesarean Section: A Randomized Controlled Trial

(Anaesthesia. 2020;75:89–95) Effective pain management after cesarean delivery is crucial both for maternal satisfaction with their delivery experience and their ability to devote their care and attention to their newborns. Neuraxial opioids have been a mainstay of postcesarean pain management, but there are significant drawbacks with these medications, including the potential for misuse. Another analgesic option for postcesarean analgesia is the quadratus lumborum block (QLB). The literature has indicated that QLB is safe and easy to perform after cesarean delivery and has shown superiority over transversus abdominis plane block. Yet, adding QLB to a standard multimodal analgesic regimen that includes intrathecal morphine has not yet been evaluated. The aim of this study was to assess the efficacy of QLB when added to a standard protocol that includes intrathecal morphine for the management of postcesarean pain after cesarean delivery.

Quadratus lumborum block for analgesia after caesarean section: a randomised controlled trial.

Quadratus lumborum block has been shown to provide satisfactory analgesia after caesarean section performed under neuraxial anaesthesia. However, its efficacy has not been demonstrated in patients who have received intrathecal morphine. The aim of this study was to assess the efficacy of quadratus lumborum block as part of a multimodal analgesic regimen including intrathecal morphine. This was a prospective, double-blind, placebo-controlled trial. Participants were randomly allocated to receive bilateral quadratus lumborum block (40ml levobupivacaine 0.25%) or sham block (control) after undergoing elective caesarean section under spinal anaesthesia. The primary outcome was 24-h morphine consumption measured by patient-controlled analgesia. Secondary outcomes included pain scores and quality of recovery. Data from 86 women were analysed. Median (IQR [range]) 24-h morphine consumption was similar in patients receiving quadratus lumborum block and sham block (12 (8-29 [0-68]) mg vs. 14 (5-25 [0-90]) mg, respectively; p=0.986). There was a reduction in median (IQR [range]) visual analogue scale pain scores at 6h with quadratus lumborum block compared with sham block both at rest (6 (0-14 [0-98]) mm vs. 14 (3-23 [0-64]) mm (p=0.019); and on movement: 23 (10-51 [0-99]) mm vs. 44 (27-61 [2-94]) mm; (p=0.014)). There was no difference in pain scores at any other time-point up to 48h. When used in conjunction with intrathecal morphine and spinal anaesthesia, bilateral quadratus lumborum block does not reduce 24-h morphine consumption after caesarean section.

Efficacy of ultrasound-guided quadratus lumborum block for analgesia after laparoscopic cholecystectomy

Objective To evaluate the efficacy of ultrasound-guided quadratus lumborum block for analgesia after laparoscopic cholecystectomy. Methods Sixty American Society of Anesthesiologists physical statusⅠorⅡ patients, aged 18-64 yr, with body mass index of 20-27 kg/m2, scheduled for elective laparoscopic cholecystectomy, were divided into 2 groups (n=30 each) using a random number table method: ultrasound-guided transversus abdominis plane block group (group T) and ultrasound-guided quadratus lumborum block group (group Q). In T and Q groups, bilateral ultrasound-guided transversus abdominis plane block and quadratus lumborum block were performed after general anesthesia induction, respectively, with 0.25% ropivacaine 20 ml for each side.All the patients received patient-controlled intravenous analgesia with morphine after surgery, and visual analoge scale scores were maintained ≤3 in the two groups.The cumulative consumption of morphine was recorded at 2, 4, 6, 12, 24 and 48 h after surgery.The occurrence of adverse reactions such as nausea, vomiting, pruritus, over-sedation and respiratory depression was observed and recorded in the analgesic period.The operation time for nerve blocks and nerve blocks-related complications such as bleeding, accidental puncture into the abdominal cavity or intestinal injuries were recorded. Results Compared with group T, the cumulative consumption of morphine was significantly decreased at 6, 12, 24 and 48 h after surgery in group Q (P 0.05). There were no adverse reactions such as nausea, vomiting, pruritus, over-sedation and respiratory depression or nerve blocks-related complications in the two groups. Conclusion Ultrasound-guided quadratus lumborum block provides better efficacy than transversus abdominis plane block when used for analgesia after laparoscopic cholecystectomy. Key words: Nerve block; Analgesia; Ultrasonography; Laparoscopy