Lateral versus posterior quadratus lumborum block in children undergoing open orchiopexy: a double-blind randomized clinical trial

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology Pub Date : 2025-07-05 DOI:10.1016/j.bjane.2025.844661

Ozgecan P. Zanbak Mutlu, Pinar Kendigelen, Ayse C. Tutuncu

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引用次数: 0

Abstract

Background

Quadratus Lumborum Block (QLB) has recently become an effective analgesic regional technique frequently used in abdominal surgeries. However, due to the heterogeneity in studies regarding block approaches, a direct comparison of QLB types is needed. In this double-blind prospective randomized trial, we aimed to compare the effects of lateral and posterior approaches of QLB on pain and analgesic use in children undergoing orchiopexy.

Methods

Patients aged 6 months – 12 years undergoing elective unilateral open orchiopexy were included in the study. Patients were randomized into two groups using the closed-envelope method. Lateral or posterior QLB was applied under ultrasonography with 0.4 mL/kg 0.25% bupivacaine for both groups before the surgery. The primary outcome was the assessment of postoperative pain for 24 hours. Analgesic usage, parental satisfaction, and complications were recorded as secondary outcomes.

Results

Analyses were conducted on 80 patients. Both study groups achieved clinically adequate analgesia, and no significant pain score distinctions were observed within 24 hours (Total mean scores: FLACC [lateral QLB: 2.86 ± 4.69 vs. posterior QLB: 2.87 ± 3.71, p = 0.466], Wong-Baker [lateral QLB: 0.86 ± 2.03 vs. posterior QLB: 1.24 ± 1.85, p = 0.151]). No significant interaction effect between groups and postoperative time intervals on pain scores was observed (FLACC score p-interaction: 0.425, Wong-Baker score p-interaction: 0.451). There were no statistical differences in the number of patients necessitating intraoperative and postoperative analgesics. Parental satisfaction exhibited similarity between the groups, and no perioperative complications were observed in either group.

Conclusion

Lateral and posterior QLB provided similar perioperative analgesia in pediatric patients undergoing orchiopexy.

Clinical trial registration number

NCT05056038.

Date of registration

02 June 2021.

查看原文本刊更多论文

接受开放性睾丸切除术的儿童腰方肌外侧与后侧阻滞：一项双盲随机临床试验。

背景：腰方肌阻滞（QLB）近年来已成为腹部手术中常用的一种有效的局部镇痛技术。然而，由于块方法研究的异质性，需要对QLB类型进行直接比较。在这项双盲前瞻性随机试验中，我们旨在比较QLB侧入路和后路入路对接受睾丸切除术的儿童疼痛和止痛药使用的影响。方法：选取年龄6个月~ 12岁的择期单侧开放睾丸切除术患者为研究对象。采用闭包法将患者随机分为两组。术前，两组均在超声检查下应用0.4 mL/kg 0.25%布比卡因治疗QLB外侧或后部。主要结果是术后24小时疼痛的评估。镇痛药使用、父母满意度和并发症被记录为次要结局。结果：对80例患者进行分析。两组患者均达到临床充分镇痛，24小时内疼痛评分无明显差异（总平均评分：FLACC[侧位QLB: 2.86±4.69 vs后位QLB: 2.87±3.71,p = 0.466]，Wong-Baker[侧位QLB: 0.86±2.03 vs后位QLB: 1.24±1.85,p = 0.151]）。各组和术后时间间隔对疼痛评分无显著交互作用（FLACC评分p-interaction: 0.425， Wong-Baker评分p-interaction: 0.451）。术中术后需要镇痛的患者数量无统计学差异。两组患者的父母满意度相似，两组患者均未出现围手术期并发症。结论：侧边和后方QLB在小儿睾丸切除术患者围术期镇痛效果相似。临床试验注册号：NCT05056038。注册日期：2021年6月2日。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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