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Background and Aims Analgesic options are limited for postoperative pain after renal transplantation. This study aimed to investigate whether a unilateral anterior quadratus lumborum block would reduce postoperative opioid consumption after living donor renal transplantation in the context of multimodal analgesia.
Methods Eighty-eight adult patients undergoing living donor renal transplantation were randomly allocated to receive either unilateral anterior quadratus lumborum block (30ml ropivacaine 0.375%) or sham block (normal saline) on the operated side. All patients received multimodal analgesia including scheduled administration of acetaminophen and a fentanyl intravenous patient-controlled analgesia. Primary outcome was total opioid consumption for the first postoperative 24 hours (oral morphine milligram equivalent [MME]). Secondary outcomes included pain scores, time to first opioid, cutaneous distribution of sensory blockade, motor weakness, nausea/vomiting, quality of recovery scores, time to first ambulate, and hospital stays.
Results Total opioid consumption in the postoperative 24 hours was not significantly different between the intervention group and control group (median [IQR], 160.5 [78–249.8] vs. 187.5 [93–309] MME; median difference [95% CI], -27 [-78 to 24], P=0.285). There were no differences in secondary outcomes.
Conclusions Anterior quadratus lumborum block did not reduce opioid consumption after living donor renal transplantation in the setting of multimodal analgesia. These findings do not support the routine administration of the anterior quadratus lumborum in this surgical population.
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