A randomized comparative study of analgesic effect of erector spinae plane block versus quadratus lumborum block for open colorectal cancer surgeries

Figures & data

Figure 1. Flow chart depicting trial phases

Table 1. Demographic data of the patients in the studied groups

Demographic data		ESPB group (n = 34)	QLB group (n = 34)	95% CI	p
Age (years)		50.85 ± 8.195	54.06 ± 7.011	−6.90, 0.49	0.088
Gender	Male	47.1% (16)	64.7% (22)		0.143
	Female	52.9% (18)	35.3% (12)
BMI (kg/m^2)		28.07 ± 4.869	28.56 ± 4.938	−2.86, 1.89	0.685
ASA	I	64.7% (22)	50.0% (17)		0.230
	II	35.3% (12)	50.0% (17)
DM		11.8% (4)	29.4% (10)		0.072
HTN		29.4% (10)	32.4% (11)		0.793
Duration of surgery (hours)		2.90 ± 0.587	2.75 ± 0.751	−0.18, 0.47	0.372

Demographic data are shown as age (mean ± SD), gender (percentage and frequency), BMI (mean ± SD), ASA physical status classification (percentage and frequency), comorbidities (percentage and frequency), and duration of surgery (mean ± SD).

Abbreviations: ESPB: erector spinae plane block; QLB: quadratus lumborum block; 95% CI: 95% confidence interval of the mean difference between both groups; n: number; P value: probability of random chance; SD: standard deviation; BMI: body mass index; kg/m [2]: kilogram per square meter; ASA: American Society of Anesthesiologists physical status classification; DM: diabetes mellitus; HTN: hypertension;*: statistically significant difference.

Table 2. Post-operative numerical rating score during rest

NRS time	ESPB group (n = 34)	QLB group (n = 34)	95% CI	p
Basal	10.00 ± 0.0	10.00 ± 0.0	-	1
PACU	50.00 ± 0.0	70.59 ± 3.430	−21.76, −19.41	˂ 0.001*
30 minutes	20.29 ± 1.715	46.47 ± 13.681	−30.90, −21.46	˂ 0.001*
60 minutes	20.00 ± 0.0	32.35 ± 7.808	−15.03, −9.68	˂ 0.001*
90 minutes	20.00 ± 0.0	41.18 ± 17.712	−27.24, −15.11	˂ 0.001*
2 hours	20.00 ± 0.0	45.88 ± 16.536	−31.54, −20.22	˂ 0.001*
6 hours	20.00 ± 0.0	30.00 ± 0.0	-	˂ 0.001*
10 hours	27.94 ± 13.434	62.06 ± 15.331	−41.10, −27.14	˂ 0.001*
14 hours	42.06 ± 13.434	37.06 ± 15.478	−2.02, 12.02	0.160
18 hours	20.00 ± 0.0	46.18 ± 19.697	−32.92, −19.43	˂ 0.001*
24 hours	20.00 ± 0.0	30.59 ± 3.430	−11.76, −9.41	˂ 0.001*
32 hours	20.00 ± 0.0	67.06 ± 7.600	−49.66, −44.46	˂ 0.001*
40 hours	50.00 ± 0.0	69.12 ± 2.879	−20.10, −18.13	˂ 0.001*
48 hours	20.00 ± 0.0	30.00 ± 0.0	-	˂ 0.001*

The difference of pain intensity during rest between the studied groups, as assessed by numeric rating scale, is expressed as mean ± SD. Differences were statistically significant at all time points except at basal and 14-hour time points.

Abbreviations: ESPB: erector spinae plane block; QLB: quadratus lumborum block; n: number; NRS: numeric rating score; 95% CI: 95% confidence interval of the mean difference between both groups; P value: probability of random chance; SD: standard deviation; PACU: post-anesthesia care unit; *: statistically significant difference.

Table 3. Post-operative numerical rating score during movement

NRS Time	ESPB group (n = 34)	QLB group (n = 34)	95% CI	p
Basal	10.00 ± 0.0	10.00 ± 0.0	-	1
PACU	69.71 ± 1.715	87.94 ± 4.104	−19.76, – 16.71	˂ 0.001*
30 minutes	50.59 ± 3.430	77.35 ± 4.478	−28.70, −24.83	˂ 0.001*
60 minutes	50.59 ± 3.430	76.47 ± 4.851	−27.92, −23.85	˂ 0.001*
90 minutes	50.59 ± 3.430	79.71 ± 6.269	−31.56, −26.67	˂ 0.001*
2 hours	50.59 ± 3.430	79.12 ± 4.518	−30.47, −26.59	˂ 0.001*
6 hours	50.59 ± 3.430	76.76 ± 4.749	−28.18, −24.17	˂ 0.001*
10 hours	55.88 ± 9.250	82.35 ± 4.306	−29.96, −22.98	˂ 0.001*
14 hours	64.12 ± 8.916	76.47 ± 4.851	−15.83, −8.88	˂ 0.001*
18 hours	49.41 ± 3.430	80.29 ± 6.735	−33.47, −28.29	˂ 0.001*
24 hours	49.41 ± 3.430	75.88 ± 4.996	−28.55, −24.40	˂ 0.001*
32 hours	30.00 ± 0.000	80.59 ± 6.001	−52.64, −48.53	˂ 0.001*
40 hours	62.06 ± 4.104	81.47 ± 5.004	−21.63, −17.20	˂ 0.001*
48 hours	30.00 ± 0.000	61.76 ± 5.205	−33.55, −29.98	˂ 0.001*

The difference in pain intensity during movement between the studied groups, as assessed by the numeric rating scale, is expressed as mean ± SD. Differences were statistically significant at all time points except the basal one.

Abbreviations: ESPB: erector spinae plane block; QLB: quadratus lumborum block; n: number; NRS: numeric rating score; 95% CI: 95% confidence interval of the mean difference between both groups; P value: probability of random chance; SD: standard deviation; PACU: post-anesthesia care unit; *: statistically significant difference.

Figure 2. Comparison of post-operative morphine consumption between the studied groups

Difference between both groups was statistically significant (p<0.05) at both time points.

Abbreviations: mg: milligram; SD: standard deviation; ESPB: erector spinae plane block; QLB: quadratus lumborum block; *: statistically significant difference.

Figure 3. Comparison of total postoperative nausea and vomiting intensity score between the studied groups

Difference between both groups was statistically insignificant (p=0.074).

Abbreviations: PONV: postoperative nausea and vomiting; ESPB: erector spinae plane block; QLB: quadratus lumborum block.

Figure 4. Comparison of the serum cortisol level between the studied groups

There was no statistically significant difference between both groups at any time point.

Abbreviations: µg/dL: microgram per deciliter; SD: standard deviation; ESPB: erector spinae plane block; QLB: quadratus lumborum block.

Figure 5. Comparison of the serum CRP level between the studied groups

Difference between both groups was statistically significant (p<0.05) in the post-operative 48-hour time point.

Abbreviations: mg/L: milligram per liter; CRP: C reactive protein; SD: standard deviation; ESPB: erector spinae plane block; QLB: quadratus lumborum block; *: statistically significant difference.

Heaney A, Buggy D. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis? Br J Anaesth. 2012;109(suppl_1):i17–i28.

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