NOMURA Takeshi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Effect of posterior quadratus lumborum blockade on the quality of recovery after major gynaecological laparoscopic surgery: A randomized controlled trial.
Journal Formal name：Anaesthesia and intensive care
Abbreviation：Anaesth Intensive Care
ISSN code：0310057X/0310057X
Domestic / ForeginForegin
Volume, Issue, Page 47(2),pp.146-151
Author and coauthor Fujimoto Hiroko, Irie Tomoya, Mihara Takahiro, Mizuno Yusuke, Nomura Takeshi, Goto Takahisa
Publication date 2019/03
Summary Bilateral quadratus lumborum blockade (QLB) using ultrasound guidance has been introduced as an abdominal truncal block to improve postoperative analgesia and quality of recovery (QoR) after abdominal surgery, but efficacy remains controversial. The primary aim of this study was to evaluate the efficacy of posterior QLB on the postoperative QoR, and secondarily to evaluate postoperative pain after gynaecological laparoscopic surgery (LS). This study was a single-centre randomized controlled trial. QLB group patients underwent bilateral posterior quadratus lumborum injections with 25-30 mL of 0.25% levobupivacaine after induction of general anaesthesia; the control group underwent no block. Both groups were administered fentanyl-based intravenous patient-controlled analgesia postoperatively. The postoperative QoR was measured using the Quality of Recovery 40 (QoR-40) questionnaire score; postoperative pain was evaluated using the visual analogue scale (VAS) and the cumulative postoperative fentanyl dose. Thirty-one and 29 patients were randomised to the QLB and control groups, respectively. The intraoperative remifentanil dosage was significantly less in the QLB group. The median (interquartile range) for the QoR-40 score was not different between the groups: 154 (133-168) in the QLB group and 158 (144-172) in the control group. There were no statistically significant differences in secondary outcome variables. Single-shot QLB did not improve the QoR or postoperative pain in patients managed by multimodal analgesia after gynaecological LS.
DOI 10.1177/0310057X19838765
PMID 31090440