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Quadratus Lumborum Block for Patients Undergoing Percutaneous Nephrolithotomy: A Randomized Controlled Study
1Department of Anesthesiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Anesthesia, Essays and Researches
|March 14, 2022
Summary
Posterior quadratus lumborum block (QLB) with ropivacaine significantly prolonged postoperative analgesia for percutaneous nephrolithotomy (PCNL) patients compared to placebo. This enhanced pain relief improved patient satisfaction and reduced analgesic consumption.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Pain Management
Background:
- Quadratus lumborum block (QLB) is increasingly recognized for postoperative pain management in renal surgery.
- Evidence supports QLB's efficacy in various surgical contexts.
Purpose of the Study:
- To evaluate the effectiveness of the posterior quadratus lumborum block (QLB) for managing postoperative pain in patients undergoing percutaneous nephrolithotomy (PCNL).
Main Methods:
- A randomized, double-blind, controlled study involving 40 patients (ASA I-III, age 18-60) undergoing unilateral PCNL.
- Ultrasound-guided posterior QLB was administered post-spinal anesthesia, using either 0.2% ropivacaine (Group Q) or normal saline (Group C).
- Primary outcome was the duration of analgesia; secondary outcomes included pain scores, patient satisfaction, and analgesic consumption.
Main Results:
- Group Q demonstrated a significantly longer duration of analgesia (1167.10 ± 89.74 min) compared to Group C (290.25 ± 47.38 min).
- Visual analog scale pain scores were significantly lower in Group Q until 20 hours post-surgery.
- Patient satisfaction was higher, and analgesic use was lower in the ropivacaine group, with similar side effect profiles.
Conclusions:
- Posterior quadratus lumborum block with ropivacaine provides effective and prolonged postoperative analgesia for PCNL.
- Further large-scale studies are warranted to establish QLB as a routine analgesic method for PCNL.
