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      Quadratus lumborum block versus transversus abdominis plane block for postoperative pain management after laparoscopic colorectal surgery : A randomized controlled trial

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          Abstract

          Background:

          This study aimed to compare the quadratus lumborum block (QLB) method with transversus abdominis plane block (TAPB) for postoperative pain management in patients undergoing laparoscopic colorectal surgery.

          Methods:

          Seventy-four patients scheduled for laparoscopic colorectal surgery were randomly assigned into 2 groups. After surgery, patients received bilateral ultrasound-guided single-dose of QLB or TAPB. Each side was administered with 20 ml of 0.375% ropivacaine. All patients received sufentanil as patient-controlled intravenous analgesia (PCIA). Resting and moving numeric rating scale (NRS) were assessed at 2, 4, 6, 24, 48 hours postoperatively. The primary outcome measure was sufentanil consumption at predetermined time intervals after surgery.

          Results:

          Patients in the QLB group used significantly less sufentanil than TAPB group at 24 and 48 hours ( P < .05), but not at 6 hours ( P = .33) after laparoscopic colorectal surgery. No significant differences in NRS results were found between the two groups at rest or during movement ( P > .05). Incidence of dizziness in the QLB group was lower than in TAPB group ( P < .05).

          Conclusions:

          The QLB is a more effective postoperative analgesia as it reduces sufentanil consumption compared to TAPB in patients undergoing laparoscopic colorectal surgery.

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          Most cited references20

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          Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Postoperative Pain After Cesarean Delivery: A Randomized Controlled Trial.

          Effective postoperative analgesia after cesarean delivery enhances early recovery, ambulation, and breastfeeding. In a previous study, we established the effectiveness of the quadratus lumborum block in providing pain relief after cesarean delivery compared with patient-controlled analgesia (morphine). In the current study, we hypothesized that this method would be equal to or better than the transversus abdominis plane block with regard to pain relief and its duration of action after cesarean delivery.
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            The Pathway of Injectate Spread With the Transmuscular Quadratus Lumborum Block: A Cadaver Study.

            The spread of injectate resulting from a transmuscular quadratus lumborum (TQL) block and a transverse oblique paramedian (TOP) TQL block has never been examined. The aim of this cadaveric study was to investigate by which pathway the injectate spreads cephalad into the thoracic paravertebral space and which nerves were dyed by the injectate cephalad and caudad to the diaphragm when performing a TQL and a TOP TQL block. We also aimed to investigate whether the thoracic and lumbar sympathetic trunks as well as the lumbar plexus were covered by the injectate.
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              The Analgesic Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block in Adult Patients: A Meta-Analysis.

              Previous meta-analyses of the transversus abdominis plane (TAP) block have examined a maximum of 12 articles, including fewer than 650 participants, and have not examined the effect of ultrasound-guided techniques specifically. Recently, many trials that use ultrasound approaches to TAP block have been published, which report conflicting analgesic results. This meta-analysis aims to evaluate the analgesic efficacy of ultrasound-guided TAP blocks exclusively for all types of abdominal surgeries in adult patients.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                December 2019
                27 December 2019
                : 98
                : 52
                : e18448
                Affiliations
                [a ]Department of Anesthesiology
                [b ]Operating Rooms, The Second Affiliated Hospital of Nanchang University, Nanchang, PR China.
                Author notes
                []Correspondence: Shuchun Yu, Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, PR China (e-mail: yscdoc11@ 123456sina.com ).
                Article
                MD-D-19-02633 18448
                10.1097/MD.0000000000018448
                6946210
                31876726
                84d512c1-128e-483b-8820-64e4dab80842
                Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

                History
                : 1 April 2019
                : 31 October 2019
                : 16 November 2019
                Categories
                3300
                Research Article
                Clinical Trial/Experimental Study
                Custom metadata
                TRUE

                laparoscopic colorectal surgery,postoperative analgesia,quadratus lumborum block,transversus abdominis plane block,ultrasound

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