Quadratus Lumborum Block and Transversus Abdominis Plane Block in Laparoscopic Nephrectomy: A Meta-Analysis

Abstract

Aim: To study the efficacy of quadratus lumborum block (QLB) and transversus abdominis plane (TAP) in laparoscopic nephrectomy patients. Materials & methods: We conducted a meta-analysis of randomized controlled trials for QLB and/or TAP technique compared with each other or a control. Results: Direct analysis of 24 h post-op pain score at rest for each compared with control showed significant reduction, QLB (mean differences [MD] [95% CI]: -1.12 [-1.87,-0.36]; p = 0.004) and TAP (MD [95% CI]: -0.36 [-0.59, -0.12]; p = 0.003). With movement both were respectively lower than control QLB (MD [95% CI]: -1.12 [-1.51, -0.72]; p = <0.0001) and TAP (MD [95% CI]: -0.50 [-0.95, -0.05]; p = 0.03). Moreover, QLB demonstrated less risk 24 h of post-op nausea vomiting (PONV) versus control (PONV; risk ratios [RR] [95% CI]: 0.64 [0.45,0.90]; p = 0.01). Conclusion: TAP and QLB reduce pain scores compared with control, whereas only QLB reduces PONV compared with control.

Keywords::

• laparoscopic nephrectomy
• quadratus lumborum
• regional anesthesia
• transversus abdominis plane block

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/pmt-2023-0033

Author contributions

AS Alvi: Conception and design of study, acquisition and interpretation of data, manuscript drafting, revisions. JA Nasir: Conception and design of study, acquisition and interpretation of data, manuscript drafting, revisions. MA Nizam: Conception and design of study, analysis of data, manuscript drafting. MM Hamdani: Acquisition and interpretation of data, manuscript drafting. NA Bhangar: Acquisition and interpretation of data, manuscript drafting. SA Sibtain: Acquisition and interpretation of data, manuscript drafting. AS Lalani: Acquisition and interpretation of data, manuscript drafting. M Warle: Design of the work, drafting of manuscript for important intellectual input, revisions. All authors approved and commented on the final version to be published and are accountable for accuracy and integrity of the manuscript

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interest disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing assistance

No writing assistance was utilized in the production of this manuscript.

Data sharing statement

The authors certify that this manuscript reports the secondary analysis of clinical trial data that has been shared with them, and that the use of this shared data is in accordance with the terms (if any) agreed upon their receipt. The source of this data is Can et al. (doi: 10.12659/AOT.893926), Bolin et al. (NCT03476850), Hosgood et al. (doi: 10.1097/TP.0b013e31825c1697), Dam et al. (doi: 10.1136/rapm-2020-101745), Cui et al. (doi: 10.24920/003759), Aniskevich et al. (doi: 10.2147/LRA.S61589), Li et al. (10.1186/s12871-019-0850-3), Parikh et al. (doi: 10.4103/1658-354X.109808), Li et al. (doi: 10.1097/EJA.0000000000001433), Kwak et al. doi (10.2147/JPR.S257466), Zhu et.al (doi:10.1186/s12871-019-0825-4), Sathianarayanan et al. doi (10.4103/ija.IJA_868_19).