Division of Medicine, Federal University of the Southern Border (Universidade Federal da Fronteira Sul), Passo Fundo, Brazil.
Affonso Guizzo Regional Hospital (Hospital Regional Affonso Guizzo), Araranguá, Brazil.
World J Surg. 2024 Mar;48(3):610-621. doi: 10.1002/wjs.12064. Epub 2024 Jan 24.
Postoperative pain management is crucial for patient recovery with Quadratus Lumborum Block (QLB) and Transversus Abdominis Plane Block (TAPB) emerging as potential techniques. We aimed to compare the analgesic efficacy of QLB and TAPB in patients undergoing inguinal hernia repair.
We performed a systematic review of Cochrane, EMBASE, and MEDLINE databases to identify randomized controlled trials comparing QLB and TAPB in patients undergoing inguinal hernia repair. Outcomes included postoperative pain and opioid consumption. Statistical analysis was performed using RevMan 5.4. The review protocol was registered at PROSPERO (CRD42023445513).
We included five RCTs encompassing 255 patients. QLB was associated with a significant decrease in postoperative pain (MD -0.45; 95% CI -0.75 to -0.14; and p = 0.004; I = 94%). However, we found no difference in 24-h opioid consumption between QLB and TAPB groups.
QLB may offer superior pain reduction. However, its effect on opioid consumption remains unclear.
术后疼痛管理对于患者的康复至关重要，QLB（竖脊肌平面阻滞）和 TAPB（腹横肌平面阻滞）作为潜在技术正在出现。我们旨在比较 QLB 和 TAPB 在腹股沟疝修补术中的镇痛效果。
我们对 Cochrane、EMBASE 和 MEDLINE 数据库进行了系统评价，以确定比较 QLB 和 TAPB 在腹股沟疝修补术中的随机对照试验。结局包括术后疼痛和阿片类药物消耗。使用 RevMan 5.4 进行统计分析。该综述方案在 PROSPERO（CRD42023445513）上进行了注册。
我们纳入了五项 RCT，共 255 名患者。QLB 与术后疼痛显著降低相关（MD -0.45；95% CI -0.75 至 -0.14；p = 0.004；I ² = 94%）。然而，我们没有发现 QLB 和 TAPB 组在 24 小时阿片类药物消耗方面存在差异。
QLB 可能提供更好的疼痛缓解，但它对阿片类药物消耗的影响尚不清楚。
