Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia in Abdominal Surgery: A Systematic Review and Meta-analysis

Background: The aim of this systematic review and meta-analysis was to compare the analgesic efficacy of the quadratus lumborum block (QLB) and transversus abdominis plane block (TAPB). Methods: We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement guidelines. Only trials comparing QLB with TAPB were included. The primary outcomes were visual analog scale (VAS) scores at rest and at movement during the first 48 h after surgery and postoperative analgesic requirements. Secondary outcomes included rates of side effects, such as postoperative nausea and vomiting (PONV) and dizziness, and patient satisfaction. Results: A total of 15 controlled trials, including 1013 patients, were identified. VAS scores at rest at 0–1, 2, 4, 6, 8, 12, and 24 h and at movement at 24 and 48 h were significantly lower in patients who underwent QLB when compared with those in patients who underwent TAPB. QLB performed better in terms of postoperative analgesic requirements, with patients requiring lower levels of intravenous morphine and sufentanil over the first 24 h, fewer patients requiring rescue analgesics, and longer times to first rescue analgesic. Among patients who underwent QLB, rates of PONV and dizziness were lower and the Bruggemann comfort scale (BCS) scores were higher. Conclusion: QLB leads to significantly better outcomes in terms of postoperative VAS scores, opioid consumption, incidence of side effects, and patient satisfaction when compared with TAPB following abdominal surgery.