Pre-emptive quadratus lumborum block for laparoscopic bariatric surgery: a prospective randomized controlled study

Abstract Background Laparoscopic bariatric surgeries in morbidly obese patients have shown a steep rise recently. Quadratus lumborum block (QLB) has been used to decrease pain in various kinds of surgeries. The purpose of this study is to evaluate the ability of pre-emptive QLB to decrease intra- and postoperative pain and opioid consumption. Results Intraoperative HR and MAP were significantly lower in the QLB group starting 20 min after block initiation. Intraoperative additional fentanyl requirements, postoperative NRS scores at rest and with movement, nausea and vomiting and the consumption of rescue analgesia were also significantly lower in the QLB group for 12 h. Early ambulation was recorded in the QLB group. Conclusions Our results suggest that bilateral posterior QLB reduced intra- and postoperative pain during laparoscopic bariatric surgeries and decreased opioid requirements and side effects.

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Postoperative Pain Treatment with Transmuscular Quadratus Lumborum Block and Fascia Iliaca Compartment Block in Patients Undergoing Total Hip Arthroplasty: A Randomized Controlled Trial

10.21203/rs.3.rs-152378/v1 ◽

2021 ◽

Author(s):

Qin Xia ◽

Wenping Ding ◽

Chao Lin ◽

Jiayi Xia ◽

Yahui Xu ◽

...

Keyword(s):

Postoperative Pain ◽

Total Hip Arthroplasty ◽

Elderly Patients ◽

Hip Arthroplasty ◽

Controlled Study ◽

Total Hip ◽

Randomized Controlled ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum ◽

Fascia Iliaca Compartment Block

Abstract Background: Patients after total hip arthroplasty (THA) often suffered moderate or even severe pain, seriously affecting the early postoperative recovery. This study aimed to investigate the analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block (T-QLB) combined with fascia iliaca compartment block (FICB) for elderly patients undergoing THA.Methods: Sixty-four patients scheduled for THA were included in this randomized controlled study. The patients were divided into two groups: group Q and group QF. Before anesthesia induction, group Q was injected with 0.375% ropivacaine 40ml. In the QF group, T-QLB combined with FICB was injected with 0.375% ropivacaine 20ml, respectively. Paracetamol 1g regularly at 6 h intervals and patient-controlled intravenous analgesia (PCIA) were administrated in both groups postoperatively. The primary outcome was cumulative sufentanil consumption via PCIA on postoperative 24 h. The secondary outcomes included pain degree, time to the first analgesic requirement, range of motion, quality of recovery, and the incidence of postoperative complications.Results: Compared with the group Q, the cumulative sufentanil consumption were significantly lower in group QF at 6-12, 12-18, 18-24, and 24h (49.29±16.76 vs. 31.42±18.81μg, P <0.001) after surgery. The postoperative pain intensity was lower in group QF at rest after 6, 12, and 24 h (P <0.05) and at activity after 6, 12, 18, and 24 h (P <0.05). Group QF had higher Qor-15 scores at postoperative 24 h and 48 h (P <0.001) and longer duration before the first opioid require via PCIA (P <0.001) postoperatively than group Q. There was no statistically significant difference between the two groups for complications postoperatively of elderly.Conclusions: Our study provides a multimodal, opioid-sparing analgesic regimen for elderly patients in THA. The combination of T-QLB and FICB provides a significant advantage for early postoperative functional recovery. Further studies are required to confirm the minimum effective dose.Trial registration: Chinese Clinical Trial Registry(ChiCTR2000038686).

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