Key result
Quadratus lumborum block significantly reduced cumulative postoperative intravenous opioid consumption at 24 hours by a mean difference of 11.51 mg morphine equivalents compared to control.
Why the study?
Does quadratus lumborum block reduce postoperative opioid consumption and pain in women undergoing cesarean section?
Meta-Analysis (n=1,269)
Does quadratus lumborum block reduce postoperative opioid consumption and pain in women undergoing cesarean section?
Mean Difference: -11.51 (95% CI -17.05–-5.96)
p-value: p=<0.01
Quadratus lumborum block significantly reduces postoperative opioid consumption and pain scores in women undergoing cesarean section.
Supports quadratus lumborum block in multimodal regimens to curb opioid exposure; confirms pooled efficacy across randomized trials.
The aim of this study was to assess the analgesic efficacy of QLB versus controls in women undergoing cesarean section (CS). We systematically searched Cochrane Library, PUBMED, EMBASE, VIP, WANFANG, and China National Knowledge Infrastructure. Trials were eligible if parturients received QLB during CS. GRADE system was used to assess the certainty of evidence and Trial sequential analyses (TSA) were performed to determine whether the results are supported by sufficient data. Thirteen studies involving 1269 patients were included. Compared to controls, QLB significantly reduced the cumulative postoperative intravenous opioid consumption (in milligram morphine equivalents) at 24 h (MD, - 11.51 mg; 95% CI - 17.05 to - 5.96) and 48 h (MD, - 15.87 mg; 95% CI - 26.36 to - 5.38), supported by sufficient data confirmed by TSA. The postoperative pain scores were significantly reduced by QLB at 4 h, 6 h, 12 h, 24 h, and 48 h postoperatively by QLB compared with control. Moreover, the time to first request for rescue analgesic and the incidence of PONV were also significantly reduced by QLB. The quality of evidence of most results were low and moderate assessed by GRADE.
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Xu et al. (2021) conducted a meta-analysis in Cesarean section (n=1,269). Quadratus lumborum block vs. Systemic analgesia alone (no block or sham block) was evaluated on Cumulative postoperative intravenous opioid consumption (in milligram morphine equivalents) at 24 h (MD -11.51, 95% CI -17.05 to -5.96, p=<0.01). Quadratus lumborum block significantly reduced cumulative postoperative intravenous opioid consumption at 24 hours by a mean difference of 11.51 mg morphine equivalents compared to control.
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