Modified versus traditional subcostal anterior quadratus lumborum block for postoperative analgesia after...

To examine the ramifications of both the modified and traditional subcostal anterior quadratus lumborum block (SQLB) on postoperative analgesia in individuals undergoing laparoscopic nephrectomy.

Forty-six individuals slated for elective laparoscopic nephrectomy under general anesthesia were randomly assigned to acquire either traditional or modified SQLB using 20 mL of 0.5% ropivacaine. The primary outcome was intravenous morphine-equivalent intake during the first 24 h following surgery. Secondary outcomes included sensory block dermatomes, numerical rating scale (NRS) scores, the total number of patient-controlled analgesia (PCA) demands, rescue analgesic use, and complications related to opioids and nerve block.

The modified SQLB group had significantly lower morphine-equivalent consumption compared to the traditional SQLB group within the initial 24 h after surgery (23.1 ± 4.3 vs. 34.7 ± 6.8 mg, P < 0.001). The modified SQLB also resulted in a greater number of dermatome segments of sensory block at 5, 10, and 15 min after block (P < 0.05), lower NRS pain scores at rest and during coughing at 6, 24, and 48 h (P < 0.001), and reduced usage of rescue analgesics as well as total PCA demands (P < 0.05). No significant differences were observed in the incidence of complications related to opioids or the nerve block procedure between the two groups.

Ultrasound-guided modified SQLB confers significantly superior analgesic advantages over the traditional SQLB for patients undergoing laparoscopic nephrectomy, culminating in a marked reduction in postoperative opioid consumption and more efficacious pain management.