Bloqueo del plano serrato intercostal frente al bloqueo del cuadrado lumbar posterior en nefrectomía laparoscópica: estudio aleatorizado, controlado, doble ciego

Abstract

Background

Even though laparoscopic nephrectomy improves the quality of postoperative recovery, it still causes moderate to severe pain. Our objective was to determine whether serratus intercostal plane block (SIPB) was noninferior to posterior quadratus lumborum block (QLB) in terms of pain control and quality of recovery.

Methods

This multicentre, controlled, randomized, blinded study had a sample size of 120 patients who were randomly assigned to SIPB, QLB, and control groups prior to scheduled laparoscopic nephrectomy. We collected the following variables: postoperative dynamic pain scores at 0, 6, 12, and 24 hours, postoperative quality of recovery (QoR15), and total opioid consumption (fentanyl and morphine).

Results

Our results show that SIPB was non-inferior to QLB with regard to the primary endpoint (NRS 0.4/0.9) and quality of recovery (QoR15 112.7/106.85) (P .27). Opioid consumption (fentanyl P .37 and morphine P .9) was similar in the SIPB and QLB groups, and both groups were superior to controls in terms of intraoperative fentanyl consumption (P .001) and pain control (P <.001).

Conclusions

SIPB and QLB showed adequate postoperative pain control, good quality of recovery and lower fentanyl consumption, especially compared to the control group.