Background and Aims Posterior quadratus lumborum block is accepted analgesic strategy in abdominal surgery. We examined whether bilateral, single-injection posterior quadratus lumborum block with ropivacaine could improve on postoperative analgesia compared to 0.9% saline in patients undergoing laparoscopic hepatectomy.

Methods Ninety-four patients were randomized to receive bilateral posterior quadratus lumborum block (20 mL of 0.375% ropivacaine on each side, 150 mg total) or control group (20 mL of 0.9% saline on each side). Primary outcome was cumulative opioid consumption during the first 24 h after surgery. Secondary outcomes included pain scores, intraoperative parameters and recovery parameters.

Results Mean cumulative opioid consumption during the first 24 h after surgery was 31.2 ± 22.4 mg in quadratus lumborum block group (n=46) and 34.5 ±

19.4 mg in control group (n=46, mean difference: -3.3 mg, 95% confidence interval, -12.0 to 5.4, p=0.453). Median resting pain score at 1 h post- surgery was significantly lower in quadratus lumborum block group (5 [4, 6.25] vs. 7 [4.75, 8] , p=0.035). There were no significant differences in resting or coughing pain scores at other time points and other secondary outcomes.

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Abstract EP113 Figure 1

Cumulative opioid consumption converted to IV morphine equivalent dose (mg) during the 48 h after surgery. The solid lines in the box indicate the medians, symbol (+) indicates means, the boxes indicate interquartile ranges, and the whiskers indicate minimum to maximum. The individual P values result from a Bonferroni correction for multiple comparisons. Abbreviations: QLB, Quadratus lumborum block

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Abstract EP113 Figure 2

Box and whiskers plot of the numeric rating scale (NRS) pain scores at rest (A) and coughing (B) during the 48 h after surgery. The solid lines in the box indicate the medians, symbol (+) indicates means, the boxes indicate interquartile ranges, and the whiskers indicate minimum to maximum. The individual P values result from a Bonferroni correction for multiple comparisons. Abbreviations: NRS, numerical rating scale; QLB, Quadratus lumborum block

Conclusions Bilateral posterior quadratus lumborum block did not reduce the cumulative opioid consumption during the first 24 h after laparoscopic hepatectomy.

ethics committee approval