Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Transmuscular Quadratus Lumborum Block for Analgesia after Elective Cesarean Section: A Randomized Controlled Trial
Several studies have shown the effectiveness of trans-muscular quadratus lumborum block (TQLB) in analgesia after cesarean delivery. However, the influence of anterior QLB at the lateral supra-arcuate ligament (QLB-LSAL) in this surgery is unclear. This study aimed to compare the analgesic efficacy...
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| Format: | Article |
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MDPI AG
2022-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/13/3827 |
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| author | Min Guo Bo Lei Huili Li Xiaoru Gao Tianshu Zhang Ziwei Liang Yun Wang Lei Wang |
| author_facet | Min Guo Bo Lei Huili Li Xiaoru Gao Tianshu Zhang Ziwei Liang Yun Wang Lei Wang |
| author_sort | Min Guo |
| collection | DOAJ |
| description | Several studies have shown the effectiveness of trans-muscular quadratus lumborum block (TQLB) in analgesia after cesarean delivery. However, the influence of anterior QLB at the lateral supra-arcuate ligament (QLB-LSAL) in this surgery is unclear. This study aimed to compare the analgesic efficacy of bilateral TQLBs with bilateral QLBs-LSAL following cesarean delivery. Ninety-four parturients scheduled for cesarean delivery under spinal anesthesia were enrolled and randomly allocated to undergo either bilateral TQLBs or bilateral QLBs-LSAL with 0.375% of ropivacaine (20 mL each side) following cesarean delivery. Intravenous sufentanil was administered for patient-controlled analgesia (PCA). The primary outcome was postoperative sufentanil consumption during the initial 24 h post-surgery. Secondary endpoints included pain scores, time to the first PCA request, postoperative rescue analgesia, satisfaction scores, and nausea/vomiting events. Sufentanil consumption was significantly reduced in the QLB-LSAL group in the first 24 h compared with the TQLB group after surgery (29.4 ± 5.7 μg vs. 39.4 ± 9.6 μg, <i>p</i> < 0.001). In comparison with TQLB, the time to the first PCA request in the QLB-LSAL group was significantly longer (10.9 ± 4.1 h vs. 6.7 ± 1.8 h, <i>p</i> < 0.001). No differences were observed between two groups regarding pain scores, rescue analgesia after surgery, satisfaction scores, or nausea/vomiting incidence. The significant reduction in opioid consumption in the first 24 h and prolongation in time to first opioid demand in parturients receiving QLB-LSAL compared with TQLB suggest that the QLB-LSAL is a superior choice for multimodal analgesia after cesarean delivery. |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T04:04:44Z |
| publishDate | 2022-07-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-95641aeda7fc48c793d2e7b59dda1ab92023-12-03T14:08:41ZengMDPI AGJournal of Clinical Medicine2077-03832022-07-011113382710.3390/jcm11133827Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Transmuscular Quadratus Lumborum Block for Analgesia after Elective Cesarean Section: A Randomized Controlled TrialMin Guo0Bo Lei1Huili Li2Xiaoru Gao3Tianshu Zhang4Ziwei Liang5Yun Wang6Lei Wang7Department of Anesthesiology, Beijing Haidian Maternal & Child Health Hospital, Beijing 100080, ChinaDepartment of Anesthesiology, Beijing Haidian Maternal & Child Health Hospital, Beijing 100080, ChinaDepartment of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, ChinaDepartment of Anesthesiology, Beijing Haidian Maternal & Child Health Hospital, Beijing 100080, ChinaDepartment of Anesthesiology, Beijing Haidian Maternal & Child Health Hospital, Beijing 100080, ChinaDepartment of Anesthesiology, Beijing Haidian Maternal & Child Health Hospital, Beijing 100080, ChinaDepartment of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, ChinaDepartment of Anesthesiology, Beijing Haidian Maternal & Child Health Hospital, Beijing 100080, ChinaSeveral studies have shown the effectiveness of trans-muscular quadratus lumborum block (TQLB) in analgesia after cesarean delivery. However, the influence of anterior QLB at the lateral supra-arcuate ligament (QLB-LSAL) in this surgery is unclear. This study aimed to compare the analgesic efficacy of bilateral TQLBs with bilateral QLBs-LSAL following cesarean delivery. Ninety-four parturients scheduled for cesarean delivery under spinal anesthesia were enrolled and randomly allocated to undergo either bilateral TQLBs or bilateral QLBs-LSAL with 0.375% of ropivacaine (20 mL each side) following cesarean delivery. Intravenous sufentanil was administered for patient-controlled analgesia (PCA). The primary outcome was postoperative sufentanil consumption during the initial 24 h post-surgery. Secondary endpoints included pain scores, time to the first PCA request, postoperative rescue analgesia, satisfaction scores, and nausea/vomiting events. Sufentanil consumption was significantly reduced in the QLB-LSAL group in the first 24 h compared with the TQLB group after surgery (29.4 ± 5.7 μg vs. 39.4 ± 9.6 μg, <i>p</i> < 0.001). In comparison with TQLB, the time to the first PCA request in the QLB-LSAL group was significantly longer (10.9 ± 4.1 h vs. 6.7 ± 1.8 h, <i>p</i> < 0.001). No differences were observed between two groups regarding pain scores, rescue analgesia after surgery, satisfaction scores, or nausea/vomiting incidence. The significant reduction in opioid consumption in the first 24 h and prolongation in time to first opioid demand in parturients receiving QLB-LSAL compared with TQLB suggest that the QLB-LSAL is a superior choice for multimodal analgesia after cesarean delivery.https://www.mdpi.com/2077-0383/11/13/3827quadratus lumborum blocklateral supra-arcuate ligamentcesarean deliverypainopioid |
| spellingShingle | Min Guo Bo Lei Huili Li Xiaoru Gao Tianshu Zhang Ziwei Liang Yun Wang Lei Wang Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Transmuscular Quadratus Lumborum Block for Analgesia after Elective Cesarean Section: A Randomized Controlled Trial Journal of Clinical Medicine quadratus lumborum block lateral supra-arcuate ligament cesarean delivery pain opioid |
| title | Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Transmuscular Quadratus Lumborum Block for Analgesia after Elective Cesarean Section: A Randomized Controlled Trial |
| title_full | Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Transmuscular Quadratus Lumborum Block for Analgesia after Elective Cesarean Section: A Randomized Controlled Trial |
| title_fullStr | Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Transmuscular Quadratus Lumborum Block for Analgesia after Elective Cesarean Section: A Randomized Controlled Trial |
| title_full_unstemmed | Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Transmuscular Quadratus Lumborum Block for Analgesia after Elective Cesarean Section: A Randomized Controlled Trial |
| title_short | Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Transmuscular Quadratus Lumborum Block for Analgesia after Elective Cesarean Section: A Randomized Controlled Trial |
| title_sort | anterior quadratus lumborum block at the lateral supra arcuate ligament versus transmuscular quadratus lumborum block for analgesia after elective cesarean section a randomized controlled trial |
| topic | quadratus lumborum block lateral supra-arcuate ligament cesarean delivery pain opioid |
| url | https://www.mdpi.com/2077-0383/11/13/3827 |
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