Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial

Abstract Background Recently, several case reports and limited randomized studies have shown that quadratus lumborum blocks (QLB) are effective in providing pain relief after intra-abdominal and retroperitoneal operations. Additionally, robot-assisted partial nephrectomy (RAPN) has been proposed as...

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Autores principales:	Renchun Lai, Quehua Luo, Jielan Lai, Xiaoyun Lu, Mei Xu
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7f1a78ca81714495a3a23138bf5b90fd
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spelling	oai:doaj.org-article:7f1a78ca81714495a3a23138bf5b90fd2021-11-28T12:28:08ZUltrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial10.1186/s13063-021-05815-31745-6215https://doaj.org/article/7f1a78ca81714495a3a23138bf5b90fd2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13063-021-05815-3https://doaj.org/toc/1745-6215Abstract Background Recently, several case reports and limited randomized studies have shown that quadratus lumborum blocks (QLB) are effective in providing pain relief after intra-abdominal and retroperitoneal operations. Additionally, robot-assisted partial nephrectomy (RAPN) has been proposed as a promising operative treatment for renal carcinoma because it enables early recovery and ambulation. Therefore, we aimed to evaluate the analgesic and opioid-sparing effects of a single-injection QLB in patients undergoing RAPN to determine its role in an early recovery program. Methods Fifty-six patients undergoing elective RAPN under general anesthesia were randomized to two equally sized groups. Patients were randomly allocated to receive either a unilateral QLB (n = 28) with 0.375% bupivacaine 0.5 mL/kg (QLB group) or a conventional scheme (n = 28) (control group). The QLB technique, termed QLB2, was performed as first described by Blanco. The primary outcome was visual analog scale (VAS) scores with movement at 6 h postoperatively. The secondary endpoints were morphine consumption at different time periods after surgery, morphine-related side effects, and assessment of postoperative rehabilitation. Results Both the VAS pain scores and cumulative opioid consumption were significantly lower in the QLB group at 6 h after surgery as compared with results in the control group (all P < 0.05). There were significant differences in pain scores at all time points except at 4 h with movement and 48 h at rest. However, at 12–24 h no significant differences between the two groups were observed in cumulative opioid consumption or in the duration of PACU and hospital stays. The patient recovery scores were significantly higher in the QLB group. Conclusions Single-injection pre-emptive QLB applied to RAPN was effective and provided satisfactory analgesia and opioid-sparing effects in combination with typical patient-controlled analgesia. In addition, it may provide an effective technique for early recovery in the perioperative period for RAPN.Renchun LaiQuehua LuoJielan LaiXiaoyun LuMei XuBMCarticleMedicine (General)R5-920ENTrials, Vol 22, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Renchun Lai Quehua Luo Jielan Lai Xiaoyun Lu Mei Xu Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial
description	Abstract Background Recently, several case reports and limited randomized studies have shown that quadratus lumborum blocks (QLB) are effective in providing pain relief after intra-abdominal and retroperitoneal operations. Additionally, robot-assisted partial nephrectomy (RAPN) has been proposed as a promising operative treatment for renal carcinoma because it enables early recovery and ambulation. Therefore, we aimed to evaluate the analgesic and opioid-sparing effects of a single-injection QLB in patients undergoing RAPN to determine its role in an early recovery program. Methods Fifty-six patients undergoing elective RAPN under general anesthesia were randomized to two equally sized groups. Patients were randomly allocated to receive either a unilateral QLB (n = 28) with 0.375% bupivacaine 0.5 mL/kg (QLB group) or a conventional scheme (n = 28) (control group). The QLB technique, termed QLB2, was performed as first described by Blanco. The primary outcome was visual analog scale (VAS) scores with movement at 6 h postoperatively. The secondary endpoints were morphine consumption at different time periods after surgery, morphine-related side effects, and assessment of postoperative rehabilitation. Results Both the VAS pain scores and cumulative opioid consumption were significantly lower in the QLB group at 6 h after surgery as compared with results in the control group (all P < 0.05). There were significant differences in pain scores at all time points except at 4 h with movement and 48 h at rest. However, at 12–24 h no significant differences between the two groups were observed in cumulative opioid consumption or in the duration of PACU and hospital stays. The patient recovery scores were significantly higher in the QLB group. Conclusions Single-injection pre-emptive QLB applied to RAPN was effective and provided satisfactory analgesia and opioid-sparing effects in combination with typical patient-controlled analgesia. In addition, it may provide an effective technique for early recovery in the perioperative period for RAPN.
format	article
author	Renchun Lai Quehua Luo Jielan Lai Xiaoyun Lu Mei Xu
author_facet	Renchun Lai Quehua Luo Jielan Lai Xiaoyun Lu Mei Xu
author_sort	Renchun Lai
title	Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial
title_short	Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial
title_full	Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial
title_fullStr	Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial
title_full_unstemmed	Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial
title_sort	ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7f1a78ca81714495a3a23138bf5b90fd
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Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial

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