scholarly journals Transmuscular quadratus lumborum block for postoperative pain and recovery after laparoscopic adrenalectomy: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Yuan ◽  
Sufang Lu ◽  
Xulei Cui ◽  
Yuelun Zhang ◽  
Yi Xie ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Laparoscopic Adrenalectomy ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Postoperative Recovery ◽  
Single Shot ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum

Abstract Background To investigate the role of transmuscular quadratus lumborum block (TMQLB) for postoperative pain control, patient satisfaction and recovery in laparoscopic adrenalectomy. Methods Seventy-two patients aged between 18 and 70 years with an ASA I-II and scheduled for laparoscopic adrenalectomy were randomized to receive a single-shot TMQLB with 0.4 ml/kg 0.5 % ropivacaine or 0.4 ml/kg 0.9 % saline as placebo. The primary endpoint was pain on movement at 12 h after surgery evaluated by the numeric rating scale (NRS, 0–10). P-values < 0.05 was considered statistically significant. The secondary outcomes included pain at rest and pain on movement evaluated by the NRS, and postoperative recovery related parameters. Results NRS on movement at 12 h after surgery was lower in the TMQLB group compared with the control (median 2 vs. 3, p = 0.024). Intraoperative fentanyl consumption was lower in the TMQLB group (247.08 ± 63.54 vs. 285.44 ± 74.70, p = 0.022). The rate of using postoperative rescue tramadol was also lower in the TMQLB group (5.6 vs. 27.8 %, p = 0.027). Similar incidences of nausea and vomiting were observed (11.1 vs. 25 %, p = 0.220). Patient satisfaction of pain service was better in the TMQLB group (83.3 vs. 25 %, p < 0.001) with shorter time to ambulation (16.5 vs. 21 h, p = 0.004) and flatus (18.5 vs. 23.5 h, p = 0.006). Conclusions TMQLB showed better control of postoperative pain on movement for laparoscopic adrenalectomy with improved patients’ satisfaction of anesthesia, shorter time to ambulation and flatus. Trial registration This study was registered at Clinicaltrials.gov (NCT03942237; registration date: 08/05/2019; enrollment date: 10/05/2019).

scholarly journals Anterior quadratus lumborum block for postoperative recovery after total hip arthroplasty: a study protocol for a single-center, double-blind, randomized controlled trial

2019 ◽  
Author(s):  
Masaru Kikuchi ◽  
Takahiro Mihara ◽  
Yusuke Mizuno ◽  
Hiroko Fujimoto ◽  
Sachiko Arai ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lower Limb ◽  
Controlled Trial ◽  
Postoperative Recovery ◽  
Double Blind ◽  
Total Hip ◽  
Randomized Controlled ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum

Abstract Background: Appropriate pain management is essential to improve the postoperative recovery after total hip arthroplasty (THA). Various case reports have indicated that anterior quadratus lumborum block (QLB) provides effective postoperative analgesia in lower limb surgeries. However, there are few randomized controlled trials that have confirmed the efficacy of anterior QLB for lower limb surgeries. The aim of this single-center, double-blind, randomized controlled trial is to confirm the efficacy of anterior QLB for postoperative recovery after THA. Methods: The participants will be randomly assigned to either the anterior QLB group or the placebo group. After induction of general anesthesia, anterior QLB will be performed using 0.25% levobupivacaine or normal saline. Fentanyl will be administered according to blood pressure change during the surgery. The primary outcome will be the quality of recovery 40 score (QoR-40). Secondary outcomes will include the visual analog scale (VAS) score of pain intensity at rest and movement, intraoperative and postoperative doses of fentanyl, and incidence of postoperative nausea and vomiting. Statistical analysis will be performed using the Student’s t-test, Mann–Whitney U-test, and Fisher’s exact test as appropriate. A p < 0.05 will be considered statistically significant. Discussion: The results of our study will reveal whether anterior QLB is effective for postoperative recovery after THA. Trial registration: UMIN Clinical Trials Registry, UMIN000032255. Registered on 15 April 2018. Keywords: anterior quadratus lumborum block, hip osteoarthritis, peripheral nerve block, postoperative pain, regional anesthesia, total hip arthroplasty

Effects of quadratus lumborum block regional anesthesia on postoperative pain after colorectal resection: a randomized controlled trial

2019 ◽  
Vol 34 (9) ◽  
pp. 4157-4165 ◽  
Author(s):  
Mélissa Boulianne ◽  
Pamela Paquet ◽  
Raymond Veilleux ◽  
Sébastien Drolet ◽  
Alexandre Meunier ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Postoperative Pain ◽  
Regional Anesthesia ◽  
Colorectal Resection ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum

scholarly journals Opioid-free anesthesia versus opioid-inclusive anesthesia for breast cancer surgery: a retrospective study

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Pia Di Benedetto ◽  
Massimiliano Pelli ◽  
Chiara Loffredo ◽  
Rosaria La Regina ◽  
Federico Policastro ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Retrospective Study ◽  
Postoperative Pain ◽  
Rating Scale ◽  
Postoperative Nausea And Vomiting ◽  
Numeric Rating Scale ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Anesthetic Technique

Abstract Background Breast cancer surgery is usually managed using opioid-inclusive anesthesia (OIA), although opioids are associated with several adverse events, including nausea, vomiting, and constipation. Multimodal opioid-free anesthesia (OFA) has been introduced to reduce the incidence of these side effects. In this single-center retrospective study, we investigated whether ketamine, combined with magnesium and clonidine, could effectively control postoperative pain in patients undergoing quadrantectomy, while reducing postoperative nausea and vomiting (PONV). Results A total of 89 patients submitted to quadrantectomy were included and divided into an OFA group (38 patients) and an OIA group (51 patients) according to the received anesthetic technique. Analgesia in the OIA group was based on an intraoperative infusion of remifentanil, and analgesia in the OFA consisted of an intraoperative infusion of ketamine and magnesium sulfate. Postoperative pain in both groups was managed with nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol. Postoperative pain, assessed with the numeric rating scale (NRS), requirements for additional analgesics, the incidence of PONV, and patient satisfaction evaluated using a QoR-40 questionnaire were compared between the two groups. Levels of pain at 30 min and 6, 12, and 24 h after surgery; number of paracetamol rescue doses; and the incidence of PONV were lower in the OFA group (p <0.05). Patient satisfaction was comparable in the two groups. Conclusions A combination of ketamine, magnesium, and clonidine could be more effective than opioid-based analgesia in reducing postoperative pain and lowering PONV occurrence after quadrantectomy for breast cancer.

scholarly journals Retrospective study of quadratus lumborum block for postoperative analgesia in patients undergoing percutaneous nephrolithotomy

2020 ◽  
Author(s):  
Luning Chen ◽  
Yali Tian ◽  
Jingjing Ji ◽  
Qing Sun ◽  
Xuefeng Qiu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Pain ◽  
Percutaneous Nephrolithotomy ◽  
Postoperative Analgesia ◽  
Medical Information ◽  
Single Shot ◽  
Routine Treatment ◽  
Post Surgery ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum

Abstract Background: The postoperative analgesic effect of transmuscular quadratus lumborum block (QLB-TM) in patients following lower abdominal surgeries has been identified, however, the efficacy of QLB using the lateral approach (QLB-L) is still in debate. Therefore, this retrospective study was conducted to investigate the effect of a single-shot block with QLB-L on postoperative analgesia for patients undergoing percutaneous nephrolithotomy (PCNL). Methods: The medical information of the patients undergoing PCNL was retrieved from the electronic charter system (Medisystem, Suzhou, China) in our Nanjing Drum Tower Hospital during the period of Jan/2019 to Jun/2019. Among the total of 57 patients, there are 17, 18, and 22 patients subjected to QLB-L, QLB-TM, or routine treatment respectively. The primary observational parameter was to assess postoperative pain with visual analog scales (VAS) at rest 30 min after extubation, 24 h, and 48 h after surgery respectively. The secondary observatory endpoints including the consumption of intraoperative opioids, the cumulative dose of non-steroid anti-inflammatory drugs (NSAIDs) and the incidence of adverse events related to postoperative analgesia were evaluated as well. Results: The static VAS score at 24 h after surgery and the intraoperative consumption of sufentanil were significantly lower in patients receiving either intervention of QLB-L or QLB-TM as compared with those receiving routine treatment. However, one shot of QLB had no impact on VAS scores at 30 min post-extubation, 48 h after PCNL procedure compared with the patients receiving routine treatment. The percentage of non-ambulatory patients within 24 h post-PCNL was significantly higher in the QLB-TM group compared with the routine treatment group (P = 0.04). There were no significant differences in the incidence of postoperative nausea and vomit (PONV), respiratory depression, the time for the first defecation and the length of hospital stay (LOS) among the three groups. Conclusions: QLB-L procedure exerts as equivalent as QLB-TM in terms of abrogating postoperative pain within 24 h post-surgery and decreasing intraoperative sufentanil consumption in patients undergoing PCNL procedure as well. The caution should be taken to avoid lower extremities weakness in the patients after QLB-TM within the first 24 h post-PCNL.

Sign in / Sign up

Export Citation Format

Share Document