ArticlePain and therapy2026
Analgesic Effect of Laparoscopic Versus Ultrasound-Guided Quadratus Lumborum Block in Patients Undergoing Laparoscopic Nephrectomy: A Randomized Controlled Clinical Trial.
Article in Pain and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionQuadratus lumborum block (QLB), as a trunk regional block technique, can effectively alleviate postoperative pain in renal surgery. Ultrasound-guided QLB (U-QLB) administered by anesthesiologists is one of the most commonly used techniques. Recently, QLB can be administered by surgeons with the help of laparoscopy during renal surgery. Laparoscopic-assisted QLB (L-QLB) is a new technique. However, there is still a lack of comparison between U-QLB and L-QLB. The aim of this study was to compare the analgesic effects of laparoscopic and ultrasound-guided QLB in patients undergoing laparoscopic nephrectomy.
methodsSixty patients undergoing laparoscopic nephrectomy were enrolled and randomized to receive L-QLB (group L) or U-QLB (group U) in a 1:1 ratio. A patient-controlled intravenous analgesia (PCIA) pump with sufentanil was administered after surgery. The primary outcome was cumulative sufentanil consumption within the first 24 h after surgery. Secondary outcomes consisted of the procedural time of QLB; the dermatomes of sensory block 2 h after surgery; resting and coughing visual analog scale (VAS) scores at 6, 12, 24, and 48 h postoperatively; rescue analgesia rate during the 0-48 h period after surgery; patient satisfaction with pain relief at 24 h post-surgery; and adverse events.
resultsThe cumulative sufentanil consumption within the first 24 h after surgery was significantly lower in the L group (median [IQR], 50.00 [48.00-52.00] μg) than in the U group (54.00 [48.75-59.25] μg) (Mann-Whitney U = 276.0, z = -2.234, P = 0.026). The procedural time of QLB was significantly shorter in group L than in group U (2.8 ± 0.8 min versus. 5.6 ± 1.1 min, mean difference (MD): 2.8 min, 95% CI 2.29 to 3.31, P < 0.001). Compared with the L group, the dermatomes of sensory block 2 h after surgery were significantly lower in the U group (6.9 ± 1.0 versus 6.2 ± 1.1, MD: -0.7, 95% CI -1.25 to -0.15, P = 0.014). The VAS scores during rest and coughing at 6, 12, and 24 h postoperatively were significantly lower in the L group than in the U group (P < 0.05). However, no significant difference in VAS scores between the two groups 48 h postoperatively was noted (P > 0.05). Compared with the L group, the rescue analgesia rate during the 0-48 h period after surgery was significantly higher in the U group (17.2% versus 44.8%, relative risk: 0.39, 95% CI 0.16-0.94, P = 0.023). Patients in group L had significantly higher satisfaction with pain relief 24 h postoperatively than those in group U (P = 0.037). No significant difference in adverse events was observed between the two groups (P > 0.05).
conclusionsCompared with ultrasound-guided QLB, laparoscopic QLB demonstrates favorable analgesic trends within the first 24 h after laparoscopic nephrectomy, including reduced sufentanil consumption. Furthermore, L-QLB shows a shorter procedural time, broader sensory blockade coverage, and higher patient satisfaction.
trial registrationChictr.org.cn identifier, ChiCTR2400080942.
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