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
Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Department of Anesthesiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Pain Pract. 2023 Jan;23(1):70-82. doi: 10.1111/papr.13140. Epub 2022 Jul 10.
Ultrasound-guided quadratus lumborum block (QLB) is considered a novel nerve block for postoperative pain control. However, its efficacy after urological surgery remains unclear.
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.
Systematic review with meta-analysis of randomized clinical trials.
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).
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.
Although the result is stable, heterogeneity exists in the current research.
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.
超声引导下腰方肌阻滞（QLB）被认为是一种用于术后疼痛控制的新型神经阻滞方法。然而，其在泌尿外科手术后的疗效仍不明确。
本荟萃分析的目的是评估QLB阻滞与对照（安慰剂或不注射）相比对泌尿外科手术后疼痛及其他不良结局的影响，为腰方肌阻滞是否适用于泌尿外科手术后的疼痛管理提供广泛证据。
对随机临床试验进行荟萃分析的系统评价。
我们检索了PubMed、Cochrane图书馆、Embase、科学网和ClinicalTrials.gov，以收集研究QLB对泌尿外科手术后镇痛效果的研究。主要结局包括静息和活动时的视觉模拟评分（VAS）、术后24小时吗啡用量以及术后恶心呕吐（PONV）的发生率。
总体而言，共纳入13项随机对照试验（RCT），包括751例接受泌尿外科手术的患者。QLB组术后0、6、12和24小时静息或活动时的VAS评分较低，术后24小时吗啡用量较少，PONV发生率较低。
尽管结果稳定，但当前研究存在异质性。
QLB在泌尿外科手术后静息或活动时具有良好的术后镇痛效果，且术后并发症减少。然而，它仍处于初级阶段的新技术，需要进一步研究来发展。
