Ultrasound-guided Quadratus Lumborum Block for Postoperative Analgesia in Patients Undergoing Nephrectomy: A Systematic Review and Meta-analysis.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL

Annals of African Medicine Pub Date : 2025-08-04 DOI:10.4103/aam.aam_108_25

Priyanka Shrivastava, Ridhima Sharma, Khushboo Saran, Jay Prakash, Amit Kumar, Khushboo Shrivastava, Ramesh Kumar Kharwar, Dipali Singh, Saket Verma

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引用次数: 0

Abstract

Background: Ultrasound-guided quadratus lumborum block (QLB) is used for intraoperative and postoperative pain relief in laparoscopic total and partial nephrectomy. The analgesic efficacy of QLB in nephrectomy remains under-explored and needs evaluation.

Methods: A comprehensive literature search was done to assess the effectiveness of preoperative QLB for nephrectomy. The primary objective was to evaluate postoperative opioid consumption following laparoscopic total and partial nephrectomy. In total nephrectomy, the opioid requirement was recorded at 24 h interval. In partial nephrectomy patients, postoperative opioid requirement was recorded at 6-12 h, 12-24 h and 24-48 h. The secondary objective was to assess the incidence of nausea and vomiting in both the groups.

Results: Single-shot QLB was compared with no block or sham block in laparoscopic total and partial nephrectomy. In total laparoscopic nephrectomy, significant reduction of postoperative opioid consumption in patients with QLB (weighted mean difference [WMD]: -549.11, 456.07; P = 0.004) than the control group seen. Nausea was 35% lower in the QLB group than the control group (risk ratio [RR]: 0.65, 95% confidence interval [CI]: 0.39-1.10). In partial nephrectomy, QLB group had less opioid use at 6-12 h (WMD: -6.23, 95% CI: -9.76--2.70), 12-24 h (WMD: -5.40, 95% CI: -10.10--0.70) and 24-48 h (WMD: -1.12, 95% CI: -6.52-4.29). Partial nephrectomy group QLB showed 28% decrease in the vomiting than the control group (RR: 0.72, 95% CI: 0.3-1.50).

Conclusion: Significant reduction in the requirement of postoperative opioid, nausea and vomiting in group receiving single-shot QLB in laparoscopic nephrectomy patients was seen. The results suggest that QLB can serve as an important part of multimodal analgesia strategies.

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超声引导腰方肌阻滞用于肾切除术患者术后镇痛：系统回顾和荟萃分析。

背景：超声引导下腰方肌阻滞（QLB）用于腹腔镜全肾和部分肾切除术术中和术后疼痛缓解。QLB在肾切除术中的镇痛效果有待进一步研究和评价。方法：通过文献检索，评价术前QLB在肾切除术中的有效性。主要目的是评估腹腔镜下全肾和部分肾切除术后阿片类药物的消耗。在全肾切除术中，每隔24小时记录阿片类药物的需求量。在部分肾切除术患者中，记录术后6-12小时、12-24小时和24-48小时阿片类药物需求。次要目的是评估两组患者恶心和呕吐的发生率。结果：腹腔镜全肾和部分肾切除术中，单次QLB与无阻滞和假阻滞比较。腹腔镜全肾切除术中，QLB患者术后阿片类药物消耗显著减少(加权平均差[WMD]: -549.11, 456.07；P = 0.004)。QLB组恶心发生率比对照组低35%（风险比[RR]: 0.65, 95%可信区间[CI]: 0.39-1.10）。在部分肾切除术中，QLB组在6-12小时（WMD: -6.23, 95% CI: -9.76—2.70）、12-24小时（WMD: -5.40, 95% CI: -10.10—0.70）和24-48小时（WMD: -1.12, 95% CI: -6.52—4.29）时阿片类药物使用较少。QLB组呕吐比对照组减少28% （RR: 0.72, 95% CI: 0.3 ~ 1.50）。结论：腹腔镜肾切除术患者单次QLB组术后阿片类药物的需要量、恶心呕吐明显减少。结果表明，QLB可作为多模式镇痛策略的重要组成部分。

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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来源期刊

Annals of African Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

0.90

自引率

0.00%

发文量

期刊介绍： The Annals of African Medicine is published by the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria and the Annals of African Medicine Society. The Journal is intended to serve as a medium for the publication of research findings in the broad field of Medicine in Africa and other developing countries, and elsewhere which have relevance to Africa. It will serve as a source of information on the state of the art of Medicine in Africa, for continuing education for doctors in Africa and other developing countries, and also for the publication of meetings and conferences. The journal will publish articles I any field of Medicine and other fields which have relevance or implications for Medicine.