General Anesthesia Combined With Quadratus Lumborum Block Reduces Emergence Delirium in Children After Laparoscopic...

Area of Science:

• Pediatric Anesthesiology
• Regional Anesthesia Techniques
• Postoperative Complications

Background:

• Emergency delirium (ED) is a frequent and severe complication following pediatric surgery.
• Quadratus lumborum block (QLB) is integral to multimodal analgesia, reducing opioid use and surgical stress.
• QLB's role in mitigating ED after pediatric laparoscopic surgery requires validation.

Purpose of the Study:

• To test if adding QLB to general anesthesia decreases ED incidence in children undergoing laparoscopic procedures.
• To evaluate QLB's impact on postoperative delirium, extubation, PACU stay, opioid consumption, and pain.

Main Methods:

• A randomized trial involving 287 children (1-6 years) undergoing laparoscopic surgery.
• Participants were assigned to general anesthesia with QLB (Group G+Q) or general anesthesia alone (Group G).
• Primary outcome: ED incidence in the postanesthesia care unit (PACU); secondary outcomes included 24-hour delirium, extubation time, PACU stay, opioid use, and pain scores.

Main Results:

• Group G+Q showed significantly lower ED incidence in PACU (16.1% vs. 47.9%) and at 24 hours (3.4% vs. 11.1%) compared to Group G (P <0.001 and P <0.05, respectively).
• Extubation time was shorter in Group G+Q (18.2 min vs. 21.2 min; P <0.05).
• PACU stay was significantly shorter in Group G+Q (48.9 min vs. 57.2 min; P <0.01).

Conclusions:

• Adjunctive QLB significantly reduces the incidence of emergency delirium in pediatric patients after laparoscopic surgery.
• QLB improves recovery by shortening extubation time and PACU length of stay.
• Combining QLB with general anesthesia enhances resuscitation quality in pediatric surgical patients.