Perioperative effects of the quadratus lumborum block in percutaneous biliary drainage: a prospective randomized...

The aim of this study was to evaluate the effect of the quadratus lumborum block (QLB) on intraoperative opioid consumption in patients undergoing percutaneous biliary drainage (PBD).

A total of 57 patients who met the inclusion criteria were randomized into two groups: the sedation group (Group 1, n = 26) and the sedation with QLB group (Group 2, n = 26). The groups were compared in terms of intraoperative anesthetic consumption, vital parameters, postanesthesia care unit (PACU) recovery times, postoperative visual analog scale (VAS) scores, postoperative analgesic consumption, and clinician and patient satisfaction. The study was entered into the ClinicalTrials.gov database (Identifier: NCT06618781).

Demographic characteristics and anesthesia and surgical durations were comparable between the two groups (p > 0.05). Intraoperative total propofol and remifentanil consumption was significantly lower in Group 2 (p < 0.001). The incidence of complications was comparable between the groups (p > 0.05). Intraoperative hemodynamic stability was assessed by comparing heart rate (p > 0.05), systolic blood pressure (p = 0.043), diastolic blood pressure (p > 0.05), mean arterial pressure (p > 0.05), and end-tidal carbon dioxide (p > 0.05). Group 2 was found to be more stable in terms of systolic blood pressure. PACU recovery times were significantly shorter in Group 2 (p = 0.002). Postoperative VAS scores at the 2nd, 6th, 12th, and 24th hours, as well as the need for rescue analgesics, were significantly lower in Group 2 (p < 0.001). Clinician and patient satisfaction scores were significantly higher in Group 2 (p < 0.001).

The current findings suggest that the incorporation of QLB into anesthetic management for PBD procedures may improve perioperative outcomes by reducing intraoperative opioid requirements without an associated increase in complication rates.