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Analgesic Effect of Ultrasound-Guided Preoperative Unilateral Lateral Quadratus Lumborum Block for Laparoscopic Nephrectomy: A Randomized, Double-Blinded, Controlled Trial

Authors Kwak KH, Baek SI, Kim JK, Kim TH, Yeo J

Received 16 April 2020

Accepted for publication 19 June 2020

Published 3 July 2020 Volume 2020:13 Pages 1647—1654

DOI https://doi.org/10.2147/JPR.S257466

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Robert B. Raffa


Kyung-Hwa Kwak,1 Seung Ik Baek,1 Jay Kyoung Kim,1 Tae-Hwan Kim,2 Jinseok Yeo1

1Department of Anesthesiology and Pain Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea; 2Department of Urology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea

Correspondence: Jinseok Yeo
Department of Anesthesiology and Pain Medicine, Kyungpook National Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea
Tel +82 53-200-2644
Fax +82 53-200-2027
Email painfree@gmail.com

Purpose: The quadratus lumborum block (QLB) is a relatively new regional analgesic technique that could provide analgesia to the abdominal wall and reduce postoperative opioid consumption. We investigated the opioid-sparing effect of a unilateral lateral QLB in laparoscopic nephrectomy.
Patients and Methods: A total of 60 patients undergoing laparoscopic nephrectomy were included in the study. Patients were randomized into two groups as QLB and control group. QLB group received QLB with 25mL 0.25% ropivacaine, and the control group received 25mL 0.9% saline at anterolateral border of quadratus lumborum muscle preoperatively. Opioid consumption and the pain intensity at rest and on movement were measured at 2nd, 6th, 24th, and 48th hour postoperatively. We also assessed the time to first flatus to measure the extent of paralytic ileus and the quality of recovery-15 (QoR-15) questionnaire.
Results: Postoperative opioid consumption was significantly lower in the QLB group than in the control group at 6, 24, and 48h after surgery (P < 0.05). The pain intensity at rest and on movement was significantly lower in the QLB group than in the control group during the first 24 hours after surgery (P < 0.05). The incidence of postoperative nausea and vomiting, time to first flatus, and QoR-15 score did not show significant differences.
Conclusion: Preoperative unilateral QLB successfully decreased postoperative pain and opioid consumption after laparoscopic nephrectomy and could be an option for analgesia after laparoscopic nephrectomy.

Keywords: quadratus lumborum block, laparoscopic nephrectomy, postoperative pain, opioid consumption, ultrasound-guided block

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