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January 31, 2024Journal of Anesthesiology and Reanimation Specialists’ SocietyOpen Access

Quadratus lumborum-II block significantly prolonged the duration of effective postoperative analgesia compared to transversus abdominis plane block (mean 18.0 vs 9.5 hours, p=0.0005) in children undergoing infra-umbilical surgeries.

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Why the study?

Does Quadratus lumborum block improve the duration of effective analgesia compared to Transversus abdominis plane block in children aged 1-7 years undergoing infra-umbilical surgeries?

Population

66 children aged 1-7 years undergoing infra-umbilical surgeries under general anesthesia

Comparison

Ipsilateral ultrasound-guided Quadratus lumborum… vs Ipsilateral ultrasound-guided Transversus…

Design

RCT, randomised

Follow-up

postoperative period

Key result

Quadratus lumborum-II block significantly prolonged the duration of effective postoperative analgesia compared to transversus abdominis plane block (mean 18.0 vs 9.5 hours, p=0.0005) in children undergoing infra-umbilical surgeries.

Authors

GAG. AnbuVSVenkatesh Selvaraj

Discussion

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Member takes

Overview

May support QL-II over TAP for extended pediatric analgesia; leaves open confirmation in larger randomized trials.

Study Design

Type

RCT (n=66)

Blinding

Single-blind

Randomization

Computer-generated random numbers and concealed by the sealed envelope technique

Multicenter

No

Structured PICO

Does Quadratus lumborum block improve the duration of effective analgesia compared to Transversus abdominis plane block in children aged 1-7 years undergoing infra-umbilical surgeries?

P
Population
66 children aged 1 to 7 years undergoing infra-umbilical surgeries were randomized to receive either a Quadratus Lumborum-II block or a Transversus Abdominis Plane block and followed for 24 hours postoperatively.
I
Intervention
Ipsilateral ultrasound-guided Quadratus lumborum (QL-II) block (0.5 ml kg-1 0.2% bupivacaine)
C
Comparator
Ipsilateral ultrasound-guided Transversus abdominis plane (TAP) block (0.5 ml kg-1 0.2% bupivacaine)
O
Outcome
Duration of effective analgesia in the postoperative periodpatient reported

Main Result

Absolute Event Rate: 18% vs 9.5%

p-value: p=0.0005

Quadratus lumborum-II block provides a longer duration of effective postoperative analgesia and better parent satisfaction compared to TAP block in children undergoing infra-umbilical surgeries.

Limitations

  • Blinding of the person performing the block was not possible
  • Failed block was not possible to define
  • Hemodynamic effects were not analyzed in the two groups
  • Inclusion criteria included surgical types with overlapping surgical dermatomal distribution

Cite This Study

Anbu et al. (2024) conducted an RCT in Postoperative pain following infra-umbilical surgeries (n=66). Quadratus lumborum-II (QL-II) block vs. Transversus abdominis plane (TAP) block (0.5 ml kg-1 of 0.2% bupivacaine) was evaluated on Duration of effective analgesia in hours (time from extubation to FLACC pain score of 4 and above) (p=0.0005). Quadratus lumborum-II block significantly prolonged the duration of effective postoperative analgesia compared to transversus abdominis plane block (mean 18.0 vs 9.5 hours, p=0.0005) in children undergoing infra-umbilical surgeries.

synapsesocial.com/papers/6ab1fcb3d60282f53cb37715https://doi.org/10.54875/jarss.2024.56933
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