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Abstract
Background and aims Postoperative pain is an expected but undesirable outcome after surgery. Quadratus lumborum block (QLB) is recommended as part of a multi-modal approach for reducing postoperative pain in laparoscopic and open surgery. the aim of this study was to investigate the efficacy of a bilateral, transmuscular QLB versus traditional oral and/or parenteral analgesics solely, after laparoscopic cholecystectomy.
Methods 75 patients scheduled for ambulatory laparoscopic cholecystectomy were randomly selected to one of the following groups: 1) Group QLB. Preoperative: Ropivacaine 3,75 mg/ml, 20 ml bilaterally; 2) Placebo group. Preoperative: lsotonic saline, 20 ml bilaterally; and 3) Control group. Postoperative: Parenteral and oral analgesics. Subcutaneous wound infiltration with Ropivacaine 2 mg/ml, 20 ml was administered to all patients. Anaesthesia was induced and maintained with Propofol and Remifentanil. Opioid analgesics consumption and pain on a Numeric Rating Scale (NRS 0–10) were recorded during the stay in the recovery room, and assessed postoperatively through phone contact after 24, 48 and 168 hours, respectively. the study was approved by the Regional Committee for Medical and Health Research Ethics (ref.no. 2017/1894) and Clinical Trials (NCT03437187).
Results Duration of surgery and intraoperative consumption of analgesics were similar in all groups. the consumption of oral morphine equivalents and NRS score at 24, 48 and 168 hours postoperatively, as well as nausea and satisfaction showed no statistical differences between the groups.
Consumption of morphine equivalents
Pain score (NRS 0 – 10)
Conclusions Even though recommended, this study could not identify beneficial effects of QLB versus oral or parenteral analgesics solely.