Evidence map›Paper›PMID 40421798›Full record

Trial reportAnnals of surgery2026

Repeat Versus Single Quadratus Lumborum Block to Reduce Opioids After Open Pancreatectomy (RESQU-BLOCK): A Randomized Clinical Trial.

Brittany C Fields, Jose M Soliz, Barbra Bryce Speer, Shannon Hancher-Hodges, Keyuri U Popat, Semhar J Ghebremichael, Antoinette Van Meter, Uduak U Williams, Xuemei Wang, Hyunsoo Hwang and 9 more

Abstract readRandomized Controlled TrialClinical Trial, Phase IIComparative Study
PubMed Publisher
In one paragraph

Trial report in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Bayesian statistics: a primer for perioperative medicine clinicians.Perioperative medicine (London, England) · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Brittany C FieldsDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.ORCID 0000-0003-1424-6004
Jose M SolizDepartment of Anesthesiology and Perioperative Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0001-9937-8035
Barbra Bryce SpeerDepartment of Anesthesiology and Perioperative Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0001-6232-8624
Shannon Hancher-HodgesDepartment of Anesthesiology and Perioperative Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Keyuri U PopatDepartment of Anesthesiology and Perioperative Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0001-8564-3993
Semhar J GhebremichaelDepartment of Anesthesiology and Perioperative Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Antoinette Van MeterDepartment of Anesthesiology and Perioperative Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Uduak U WilliamsDepartment of Anesthesiology and Perioperative Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Xuemei WangDepartment of Biostatistics, Division of Discovery Science, The University of Texas MD Anderson Cancer Center, Houston, TX.
Hyunsoo HwangDepartment of Biostatistics, Division of Discovery Science, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0003-0308-5145
Morgan L BrunoDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.
Whitney L DewhurstDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.
Elsa M ArvideDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.
Naruhiko IkomaDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.ORCID 0000-0002-9825-9234
Jessica E MaxwellDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.ORCID 0000-0002-0394-5988
Michael P KimDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.
Matthew H G KatzDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.ORCID 0000-0003-3870-6968
Ching-Wei D TzengDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.
Timothy E NewhookDepartment of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson, Cancer Center, Houston, TX.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe primary aim was to compare the proportion of opioid-free discharges between 2 postoperative analgesia bundles distinguished by receipt of a single-block versus a second, "rescue" block. Secondary outcomes included differences in discharge prescription oral morphine equivalents (OME) and patient-reported outcomes.

backgroundAfter a preoperative quadratus lumborum block, our historical discharge opioid prescription for open pancreatectomy was 300 mg OME, with only 5% patients discharged opioid-free. We hypothesized an opioid-reduction bundle with repeat block on postoperative day (POD)4 could increase opioid-free discharges while reducing symptom burden.

methodsThis was a single-institution, unblinded phase II randomized clinical trial, analyzed by intention-to-treat and post hoc Bayesian analyses. Patients undergoing open pancreatectomy were randomized 1:1 to receive a standardized analgesic bundle with or without the addition of the rescue-block on POD4.

resultsAmong 106 patients randomized (44.3% female; median age 66.5 years; 84% pancreatoduodenectomy; median 5-day stay), 104 completed the trial (52 per arm). By intention-to-treat, 52% of second-block patients were discharged opioid-free versus 36.5% single-block. Median discharge OME was 0 versus 25 mg, respectively. Improved (lower) patient-reported pain and life interference scores were observed in the second-block arm at discharge and 1 month.

conclusionsAddition of a second, "rescue" block to an opioid reduction bundle did not significantly improve opioid-free discharges after open pancreatectomy and was not required to discharge >1/3 of patients opioid-free. Nevertheless, considering improvements in symptom inventory and the high threshold of opioid-free discharge, the concept of a rescue-block to purposefully wean patients to zero use is feasible.

Indexed as

Analgesics, OpioidNerve BlockPancreatectomyPostoperative PainAgedFemaleHumansMaleMiddle AgedPain ManagementPain MeasurementTreatment OutcomeAnalgesics, Opioidcancer surgeryopioid reductionoutcomesquality improvementregional anesthesia

Identifiers

PMID40421798

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.