Department of Anesthesiology, Shaoxing Maternity and Child Health Care Hospital, Shaoxing, China.
Department of Anesthesiology, Shaoxing People's Hospital, Shaoxing, China.
Langenbecks Arch Surg. 2023 Oct 18;408(1):411. doi: 10.1007/s00423-023-03149-z.
The present review was designed to differentiate between the analgesic value of transversus abdominis plane block (TAP) vs the quadratus lumborum block (QLB) for patients undergoing inguinal hernia surgery.
PubMed, CENTRAL, Scopus, Embase, Google Scholar, Open gray, and a clinical trial registry were searched up to 18 February 2023 for randomized controlled trials (RCTs) comparing TAP and QLB for inguinal hernia repair.
Six RCTs from India, Turkey, and Norway published between the years 2019 to 2023 were included. Anesthetic agents and dosages were similar for TAP and QLB groups in each study. On meta-analysis, pain scores were not statistically significant different between TAP and QLB at 3-6 h (MD: 0.46 95% CI: -0.11, 1.03 I = 86%), 12 h (MD: 1.34 95% CI: -0.12, 2.80 I = 97%), and 24 h (MD: 0.38 95% CI: -0.77, 1.53 I = 97%). Meta-analysis of total analgesic consumption showed a tendency of reduced analgesic consumption with QLB as compared to TAP but the difference was not significant (SMD: 0.69 95% CI: 0.00, 1.37 I = 83%). Data on complications was scarcely available. GRADE assessment of the evidence was low to moderate.
Low to moderate-quality preliminary evidence suggests no difference in the analgesic efficacy of TAP and QLB for adult patients undergoing inguinal hernia repair. While there was a tendency for lower postoperative analgesic consumption with QLB, it needs to be verified by future studies.
本综述旨在区分腹横肌平面阻滞（TAP）与腰方肌阻滞（QLB）在腹股沟疝手术患者中的镇痛效果。
检索 PubMed、CENTRAL、Scopus、Embase、Google Scholar、Open gray 和临床试验注册中心，截至 2023 年 2 月 18 日，以比较 TAP 和 QLB 用于腹股沟疝修补术的随机对照试验（RCT）。
纳入了来自印度、土耳其和挪威的 6 项 RCT，发表时间为 2019 年至 2023 年。每项研究中，TAP 和 QLB 组的麻醉剂和剂量相似。Meta 分析结果显示，TAP 和 QLB 组在 3-6 h（MD：0.46 95%CI：-0.11，1.03 I=86%）、12 h（MD：1.34 95%CI：-0.12，2.80 I=97%）和 24 h（MD：0.38 95%CI：-0.77，1.53 I=97%）时的疼痛评分无统计学差异。总镇痛药物消耗的 Meta 分析显示，QLB 组的镇痛药物消耗有减少的趋势，但差异无统计学意义（SMD：0.69 95%CI：0.00，1.37 I=83%）。关于并发症的数据很少。证据的 GRADE 评估为低到中度。
低到中度质量的初步证据表明，TAP 和 QLB 在成人腹股沟疝修补术中的镇痛效果无差异。虽然 QLB 术后镇痛药物消耗有减少的趋势，但需要进一步研究证实。
