Efficacy of ultrasound-guided quadratus lumborum block versus transversus abdominis plane block for analgesia after lower abdominal surgery: a meta-analysis

Abstract

Objective To systematically review and compare the efficacy of ultrasound-guided quadratus lumbosum block (QLB) and transverse abdominis plane block (TAPB) for analgesia after lower abdominal surgery. Methods Pubmed, Embase, The Cochrane Library, ISI Web of knowledge, Chinese biomedical literature database, Chinese science and technology journal full-text database, Chinese journal full-text database and Wanfang database were searched by a computer from the date of database establishment up to May 2019.Randomized controlled trials involving the efficacy of ultrasound-guided QLB and TAPB for analgesia after lower abdominal surgery were included in this study.The primary outcome was visual analog scale scores at rest and during activity at each time point after operation, and the secondary outcome was the incidence of adverse reactions (nausea and vomiting, dizziness, pruritus). The two researchers selected the literature and extracted the data according to the inclusion criteria, independently evaluated the quality of the included literature according to the relevant criteria recommended in Cochrane reviewers′ manual 5.1.0, and conducted a meta-analysis using RevMan 5.3. Results A total of 16 randomized controlled studies involving 1 218 patients were included, including 608 cases in QLB group and 610 cases in TAPB group.The results of meta-analysis showed that the visual analog scale scores at rest at 2, 4, 6, 12 and 24 h after surgery and during activity at 8 and 12 h after surgery and the incidence of nausea and vomiting were significantly decreased in QLB group as compared with TAPB group (P<0.05). Conclusion QLB can provide better early postoperative analgesia than TAPB with a lower risk of adverse reactions. Key words: Nerve block; Psoas muscles; Abdominal muscles; Analgesia; Meta-analysis