Ultrasound guided quadratus lumborum block versus interlaminar epidural block for analgesia in pediatric abdominal surgery: a randomized controlled trial.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968535 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2253 (Electronic) Linking ISSN: 14712253 NLM ISO Abbreviation: BMC Anesthesiol Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2001-

Nerve Block*/methods ; Ultrasonography, Interventional*/methods ; Pain, Postoperative*/prevention & control ; Abdomen*/surgery ; Abdominal Muscles*/diagnostic imaging; Humans ; Male ; Female ; Child ; Child, Preschool ; Anesthetics, Local/administration & dosage ; Bupivacaine/administration & dosage ; Analgesia, Epidural/methods ; Fentanyl/administration & dosage ; Analgesics, Opioid/administration & dosage

Background: Although the efficacy and safety of epidural block (EB) are fairly high, complications such as inadvertent dural puncture may limit its use. Ultrasound-guided quadratus lumborum block (QLB) is a relatively new regional technique that provides perioperative somatic and visceral analgesia for pediatric patients. This trial compared the quality of pain relief in pediatric patients undergoing abdominal surgery who received either QLB or EB.
Methods: Patients were randomly allocated into two equal groups: Group E(n = 29): received EB; Group QL(n = 29): received QLB. Both groups were injected with 0.25% bupivacaine (0.5 ml/kg). Assessment of total analgesia consumption was the primary outcome measure, whereas the secondary outcome measures were assessment of postoperative analgesic effect by Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and time of first analgesic request.
Results: Our study showed that the mean total fentanyl consumption was comparable between both groups(38.67 ± 5.02 and 36.47 ± 5.13 µg in the E and QL groups, respectively, P = 0.246). Only five patients did not require rescue analgesia (3 in the E group,2 in the QL group, P = 0.378). The mean duration of analgesia showed no significant difference between the two groups (9.9 ± 1.58 and 11.02 ± 1.74 h in the E and QL groups, respectively, P = 0.212). Evaluation of CHEOPS score values immediately in PACU and for the initial 24 h following operation showed no significant difference between the two study groups(P > 0.05).
Conclusion: QLB can achieve analgesic effects comparable to those of EB as a crucial part of multimodal analgesia in children undergoing abdominal surgeries.
Clinical Trial Registration Number: PACTR202203906027106.
(© 2024. The Author(s).)

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Keywords: Abdominal surgery; Analgesia; Epidural block; Pediatric; Quadratus lumborum block

Date Created: 20240521 Date Completed: 20240522 Latest Revision: 20240717

20240718

PMC11107015

10.1186/s12871-024-02548-z

38773360