الفهرس | Only 14 pages are availabe for public view |
Abstract Effective perioperative analgesia with laparoscopic cholecystectomy enhances early recovery, ambulation, and discharge. Subcostal TAP block has been shown to reduce perioperative opioid use and provide effective perioperative analgesia. Currently, the QLB is done for the perioperative pain management procedures for patients undergoing abdominal surgery. In this study, we assumed that posterior quadratus lumborum block might be better than or equal to the subcostal TAP block regarding the analgesia and the duration of action after laparoscopic cholecystectomy. 159 patients were randomized for elective laparoscopic cholecystectomy. They were randomly allocated to 3 equal groups, 53 patients each. First group, patients received posterior QLB plus standard intravenous analgesia. Second group, patients received subcostal TAP block plus standard intravenous analgesia. Third group received standard intravenous analgesia (control group). The study was registered at ClinicalTrials.gov (NCT03323684). Data from 149 patients were analyzed (48 patients in QLB group and 50 patients in the TAP group, and 51 in control group). The cumulative postoperative fentanyl consumption at 24 hours in patients required postoperative opioids showed no significant difference between the QLB and TAP groups but with significantly higher number of patients who did not require postoperative opioids in QLB group than in the TAP and control groups. The time to the first postoperative request for rescue analgesia was significantly longer in QLB group than in the TAP and control groups. There was no significant difference between the QLB and TAP groups as regard PONV, and pain scores at 1, 6, 12, and 24 hours postoperatively. In this study our conclusion was that posterior quadratus lumborum block could provide better effective postoperative analgesia in patients undergoing laparoscopic cholecystectomy than subcostal transversus abdominis plane block did. |