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Research article
Renchun Lai
Sun Yat-sen University Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8504-5157
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Recently, several case reports and limited randomized studies have shown that the quadratus lumborum block (QLB) is effective in providing pain relief after intra-abdominal and retroperitoneal operations. Robot-assisted partial nephrectomy (RAPN) has also been proposed as a promising operative treatment for renal carcinoma because it enables early recovery and ambulation. Therefore, we aimed to evaluate the analgesic and opioid-sparing effects of a single-injection QLB, which may paly an important role on early recovery program in RAPN.
Methods
Fifty-six patients undergoing elective RAPN under general anesthesia were randomised to two equally sized groups. Patients were randomly allocated to receive unilateral QLB (n=28) with 0.375% bupivacaine 0.5 mL/kg (QLB group) or a conventional scheme (n=28) group (Control group). The QLB technique was performed as first described by Blanco, termed QLB2. The primary outcome was the visual analogue scale (VAS) scores with movement at 6 hours postoperatively. The secondary endpoints were the morphine consumption at different time-period after surgery, morphine-related side effects and assessment of postoperative rehabilitation.
Results
Both VAS pain score and cumulative opioid consumption were significantly lower in the QLB group at 6 hours after surgery as compared with the control group (all P<0.05). There was significant difference in pain scores at any other time-point except at 4 hours on movement and 48 hours at rest. However, no significant difference was observed in 12-48 hours cumulative opioid consumption, and in the duration of PACU and hospital stay between the two groups. The patient recovery scores was significantly higher in the QLB group.
Conclusions
Single-injection pre-emptive QLB applied to RAPN was effective and provided satisfactory analgesia and opioids-sparing in combination with a typical patient-controlled analgesia. In addition, it may provide an effective technique for early recovery in perioperative period.
Keywords
Quadratus lumborum block; Ultrasound; Robot-assisted partial nephrectomy; Analgesia; Opioids-sparing
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Renchun Lai
Sun Yat-sen University Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8504-5157
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
View the published article at Trials.
Version 1
Posted 02 Apr, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Trials.
Background
Recently, several case reports and limited randomized studies have shown that the quadratus lumborum block (QLB) is effective in providing pain relief after intra-abdominal and retroperitoneal operations. Robot-assisted partial nephrectomy (RAPN) has also been proposed as a promising operative treatment for renal carcinoma because it enables early recovery and ambulation. Therefore, we aimed to evaluate the analgesic and opioid-sparing effects of a single-injection QLB, which may paly an important role on early recovery program in RAPN.
Methods
Fifty-six patients undergoing elective RAPN under general anesthesia were randomised to two equally sized groups. Patients were randomly allocated to receive unilateral QLB (n=28) with 0.375% bupivacaine 0.5 mL/kg (QLB group) or a conventional scheme (n=28) group (Control group). The QLB technique was performed as first described by Blanco, termed QLB2. The primary outcome was the visual analogue scale (VAS) scores with movement at 6 hours postoperatively. The secondary endpoints were the morphine consumption at different time-period after surgery, morphine-related side effects and assessment of postoperative rehabilitation.
Results
Both VAS pain score and cumulative opioid consumption were significantly lower in the QLB group at 6 hours after surgery as compared with the control group (all P<0.05). There was significant difference in pain scores at any other time-point except at 4 hours on movement and 48 hours at rest. However, no significant difference was observed in 12-48 hours cumulative opioid consumption, and in the duration of PACU and hospital stay between the two groups. The patient recovery scores was significantly higher in the QLB group.
Conclusions
Single-injection pre-emptive QLB applied to RAPN was effective and provided satisfactory analgesia and opioids-sparing in combination with a typical patient-controlled analgesia. In addition, it may provide an effective technique for early recovery in perioperative period.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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