Analgesic Effectiveness of Quadratus Lumborum Block for Patients after Abdominal Surgery: A Systematic Review and Meta-Analysis

Tianyu Liu1, Chao Xu2, He Zhu1, Xiuxiu Gao1, Lulu Guo1, Zeshu Shi1 and Dunyi Qi1*

1Key Laboratory of Anesthesia and Analgesia, Xuzhou Medical University and Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, China
2Department of Anesthesiology, Peking University People’s Hospital and Peking University Health Science Center, China

^*Correspondance to: Dunyi Qi 

 PDF  Full Text DOI: 10.25107/2474-1647.2815

Abstract

Background: A series of studies have reported that Quadratus Lumborum Block (QLB) can have a great postoperative analgesia for lower abdominal surgery. However, a meta-analysis of the analgesic effect of QLB in patients undergoing lower abdominal surgery has not been published. Methods: We searched the databases of Pubmed, Embase, Cochrane Library, and Web of Science (updated to October 15, 2019). We cumulative opioid consumption at 6, 12, 24 and 48 h after surgery; pain score (rest and dynamic) at 6, 12, 24 and 48 h after surgery; occurrence of common opioid-related complications at 24 h after surgery. Opioid consumption as the main outcome. Results: Thirteen Randomized Controlled Trials (RCTs) including 751 patients were analyzed. Compared with control group, QLB group can effectively reduce 24 h and 48 h cumulative opioid consumption 10.1 mg (95% CI: -13, -7.2; p<0.00001) and 16.22 mg (95% CI: -19.39, 13.03; p<0.00001) in patients with cesarean section, but can reduce effectively cumulative opioid consumption in patients undergoing laparoscopic surgery at 6, 12 and 24 h. Posterior QLB group and transmuscular QLB group reduced 24 h cumulative opioid consumption 4.03 mg (95% CI: -7.89, -0.19; p=0.04) and 12.44 mg (95% CI: -20.2, -4.68; p=0.002), respectively. QLB group reduced rest Visual Analogue Scale (VAS) score at 12, 24 and 48 h, however, the effective reduction of rest VAS score in patients undergoing cesarean section only occurs at 24 h after surgery. Conclusion: QLB seems to provide better analgesia for patients undergoing laparoscopic surgery than patients undergoing cesarean section. Transmuscular QLB appears to have reduced postoperative opioid consumption compared to posterior QLB. More future RCTs are needed to support our conclusions.

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Cite the article

Liu T, Xu C, Zhu H, Gao X, Guo L, Shi Z, et al. Analgesic Effectiveness of Quadratus Lumborum Block for Patients after Abdominal Surgery: A Systematic Review and Meta-Analysis. Clin Surg. 2020; 5: 2815..