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Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Abdominal surgery is common and is associated with severe postoperative pain. The transverse abdominal plane (TAP) block is considered an effective means for pain control in such cases. The quadratus lumborum (QL) block is another option for the management of postoperative pain. The aim...

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Autores principales: Liu, Xiancun, Song, Tingting, Chen, Xuejiao, Zhang, Jingjing, Shan, Conghui, Chang, Liangying, Xu, Haiyang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053127/
https://www.ncbi.nlm.nih.gov/pubmed/32122319
http://dx.doi.org/10.1186/s12871-020-00967-2
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author Liu, Xiancun
Song, Tingting
Chen, Xuejiao
Zhang, Jingjing
Shan, Conghui
Chang, Liangying
Xu, Haiyang
author_facet Liu, Xiancun
Song, Tingting
Chen, Xuejiao
Zhang, Jingjing
Shan, Conghui
Chang, Liangying
Xu, Haiyang
author_sort Liu, Xiancun
collection PubMed
description BACKGROUND: Abdominal surgery is common and is associated with severe postoperative pain. The transverse abdominal plane (TAP) block is considered an effective means for pain control in such cases. The quadratus lumborum (QL) block is another option for the management of postoperative pain. The aim of this study was to conduct a meta-analysis and thereby evaluate the efficacy and safety of QL blocks and TAP blocks for pain management after abdominal surgery. METHODS: We comprehensively searched PubMed, EMBASE, EBSCO, the Cochrane Library, Web of Science and CNKI for randomized controlled trials (RCTs) that compared QL blocks and TAP blocks for pain management in patients undergoing abdominal surgery. All of the data were screened and evaluated by two researchers. RevMan5.3 was adopted for the meta-analysis. RESULTS: A total of 8 RCTs involving 564 patients were included. The meta-analysis showed statistically significant differences between the two groups with respect to postoperative pain scores at 2 h (standardized mean difference [Std.MD] = − 1.76; 95% confidence interval [CI] = − 2.63 to − 0.89; p < .001), 4 h (Std.MD = -0.77; 95% CI = -1.36 to − 0.18; p = .01),6 h (Std.MD = -1.24; 95% CI = -2.31 to − 0.17; p = .02),12 h (Std.MD = -0.70; 95% CI = -1.27 to − 0.13; p = .02) and 24 h (Std.MD = -0.65; 95% CI = -1.29 to − 0.02; p = .04); postoperative morphine consumption at 24 h (Std.MD = -1.39; 95% CI = -1.83 to − 0.95; p < .001); and duration of postoperative analgesia (Std.MD = 2.30; 95% CI = 1.85 to 2.75; p < .001). There was no statistically significant difference between the two groups with regard to the incidence of postoperative nausea and vomiting (PONV) (RR = 0.55;95% CI = 0.27 to 1.14;p = 0.11). CONCLUSION: The QL block provides better pain management with less opioid consumption than the TAP block after abdominal surgery. In addition, there are no differences between the TAP block and QL block with respect to PONV.
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spelling pubmed-70531272020-03-10 Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials Liu, Xiancun Song, Tingting Chen, Xuejiao Zhang, Jingjing Shan, Conghui Chang, Liangying Xu, Haiyang BMC Anesthesiol Research Article BACKGROUND: Abdominal surgery is common and is associated with severe postoperative pain. The transverse abdominal plane (TAP) block is considered an effective means for pain control in such cases. The quadratus lumborum (QL) block is another option for the management of postoperative pain. The aim of this study was to conduct a meta-analysis and thereby evaluate the efficacy and safety of QL blocks and TAP blocks for pain management after abdominal surgery. METHODS: We comprehensively searched PubMed, EMBASE, EBSCO, the Cochrane Library, Web of Science and CNKI for randomized controlled trials (RCTs) that compared QL blocks and TAP blocks for pain management in patients undergoing abdominal surgery. All of the data were screened and evaluated by two researchers. RevMan5.3 was adopted for the meta-analysis. RESULTS: A total of 8 RCTs involving 564 patients were included. The meta-analysis showed statistically significant differences between the two groups with respect to postoperative pain scores at 2 h (standardized mean difference [Std.MD] = − 1.76; 95% confidence interval [CI] = − 2.63 to − 0.89; p < .001), 4 h (Std.MD = -0.77; 95% CI = -1.36 to − 0.18; p = .01),6 h (Std.MD = -1.24; 95% CI = -2.31 to − 0.17; p = .02),12 h (Std.MD = -0.70; 95% CI = -1.27 to − 0.13; p = .02) and 24 h (Std.MD = -0.65; 95% CI = -1.29 to − 0.02; p = .04); postoperative morphine consumption at 24 h (Std.MD = -1.39; 95% CI = -1.83 to − 0.95; p < .001); and duration of postoperative analgesia (Std.MD = 2.30; 95% CI = 1.85 to 2.75; p < .001). There was no statistically significant difference between the two groups with regard to the incidence of postoperative nausea and vomiting (PONV) (RR = 0.55;95% CI = 0.27 to 1.14;p = 0.11). CONCLUSION: The QL block provides better pain management with less opioid consumption than the TAP block after abdominal surgery. In addition, there are no differences between the TAP block and QL block with respect to PONV. BioMed Central 2020-03-02 /pmc/articles/PMC7053127/ /pubmed/32122319 http://dx.doi.org/10.1186/s12871-020-00967-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Liu, Xiancun
Song, Tingting
Chen, Xuejiao
Zhang, Jingjing
Shan, Conghui
Chang, Liangying
Xu, Haiyang
Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials
title Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials
title_full Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials
title_short Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials
title_sort quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053127/
https://www.ncbi.nlm.nih.gov/pubmed/32122319
http://dx.doi.org/10.1186/s12871-020-00967-2
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