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Randomized Controlled Trial
. 2022 Apr 30:2022:8994297.
doi: 10.1155/2022/8994297. eCollection 2022.

Ultrasound-Guided Quadratus Lumborum Block Enhances the Quality of Recovery after Gastrointestinal Surgery: A Randomized Controlled Trial

Qing-Ren Liu  1 , Yu-Chen Dai  2 , Jue Xie  2 , Xiang Li  1 , Xing-Bing Sun  1 , Jie Sun  2
Affiliations
Randomized Controlled Trial

Ultrasound-Guided Quadratus Lumborum Block Enhances the Quality of Recovery after Gastrointestinal Surgery: A Randomized Controlled Trial

Qing-Ren Liu et al. Pain Res Manag. .

Abstract

Background: Quadratus lumborum block (QLB) has been used to reduce postoperative acute pain and opioid consumption. However, the efficacy of QLB on the quality of recovery (QoR) after gastrointestinal surgery has not been established. The aim of this study was to evaluate the ability of QLB to enhance the postoperative QoR in patients undergoing open gastrointestinal surgery.

Methods: Eighty-four patients undergoing open gastrointestinal surgery were randomized to receive ultrasound-guided QLB with either 20 ml of 0.375% ropivacaine or saline. The primary outcome was the QoR-15 score at 24 h after surgery. The secondary outcomes were the postoperative pain intensity, opioid consumption, the incidence of nausea, vomiting, and chronic pain.

Results: The global QoR-15 score at 24 h postoperatively was significantly higher in the QLB group than in the control group (mean difference: 16.9; 95% CI: 11.9-21.9). Additionally, the QoR-15 scores for five dimensions were significantly higher in the QLB group than in the control group. The cumulative oxycodone consumption was significantly lower in the QLB group during 0-6, 6-24, 0-24, 24-48, and 0-48 h postoperatively than in the control group. At rest or during coughing, the pain verbal rating scale scores were significantly lower at 1, 3, 6, 12, and 24 h after surgery in the QLB group than in the control group. The incidence of postoperative nausea was significantly different between the groups, but postoperative vomiting was not.

Conclusion: Single-injection posteromedial QLB with ropivacaine enhanced the QoR at 48 h after surgery and improved analgesia during the early postoperative period in patients undergoing gastrointestinal surgery.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
CONSORT flow diagram. QLB: quadratus lumborum block.
Figure 2
Figure 2
Pain at rest and during coughing at 48 h after surgery: (a) VRS at rest and (b) NRS during coughing. Data are presented as median and interquartile range at rest or during coughing. The VRS scores were significantly lower at 1, 3, 6, 12, and 24 h after surgery in the QLB group than that in the control group. ∗P < 0.05 and ∗∗P < 0.001. QLB: quadratus lumborum block.
Figure 3
Figure 3
(a) AUC of pain VRS over time at rest, P < 0.001 and (b) AUC of pain VRS over time during coughing, P < 0.001. Data are presented as mean ± standard deviation. QLB: quadratus lumborum block, AUC: area under the curve, and VRS: verbal rating scale.
See this image and copyright information in PMC

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