Efficacy of quadratus lumborum block on postoperative pain and side effects in patients who underwent urological surgery: A meta‐analysis

• Published in: Pain practice 2023-01, Vol.23 (1), p.70-82
• Main Authors: Cai, Qiang, Liu, Guoqing, Liu, Zengchen, Gao, Meiling, Huang, Linsheng, He, Fuhai, Liu, Shangyu, Lin, Yunhua, Wei, Huixia, Dou, Zhiqian, Liu, Dexi, Hu, Yang, Gong, Xingrui
• Format: Article
• Language: English
• Subjects: Analgesics, Opioid - therapeutic use; Anesthetics, Local; Drug-Related Side Effects and Adverse Reactions; Humans; Morphine; Nerve Block - adverse effects; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Pain, Postoperative - prevention & control; postoperative analgesia; Postoperative Nausea and Vomiting; quadratus lumborum block; renal surgery; side effects; Ultrasonography, Interventional
• ISSN: 1530-7085; 1533-2500
• DOI: 10.1111/papr.13140

Background Ultrasound‐guided quadratus lumborum block (QLB) is considered a novel nerve block for postoperative pain control. However, its efficacy after urological surgery remains unclear. Objectives The purpose of the current meta‐analysis was to evaluate the effects of the QLB block versus control (placebo or no injection) on postoperative pain and other adverse outcomes after urological surgery, providing extensive evidence of whether quadratus lumborum block is suitable for pain management after urological surgery. Study design Systematic review with meta‐analysis of randomized clinical trials. Methods We searched PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov to collect studies investigating the effects of QLB on analgesia after urological surgery. The primary outcomes included visual analog scale (VAS) at rest and during movement, 24‐h postoperative morphine consumption, and the incidence of postoperative nausea and vomiting (PONV). Results Overall, 13 randomized controlled trials (RCTs) were reviewed, including 751 patients who underwent urological surgery. The QLB group exhibited a lower VAS score postoperatively at rest or on movement at 0, 6, 12, and 24 h, with less 24‐h postoperative morphine consumption and lower incidence of PONV. Limitations Although the result is stable, heterogeneity exists in the current research. Conclusions QLB exhibited a favorable effect of postoperative analgesia with reduced postoperative complications at rest or during movement after urological surgery. However, it is still a novel technology at a primary stage, which needs further research to develop.