Abstract: Objective This study aims to compare the analgesic effects of the quadratus lumborum block (QLB) with the ef⁃
fects of transversus abdominis plane block (TAPB) after laparoscopic colorectal surgery. Methods One hundred patients undergo⁃
ing laparoscopic cholecystectomy were allocated into two groups according to a random number table generated by computer: group Q (n
=46) and group T (n=41). All patients in group Q or group T were received bilateral QLB or bilateral TAPB with 0.25% ropivacaine 20 ml
on each side. Cumulative morphine dose in 24 h and the time of first requirement for morphine as well as intraoperative remifentanil
consumption and duration of post⁃anesthesia care unit (PACU) were recorded. Pain (visceral and incisional, at rest and on movement)
was assessed at 2, 12, 24 h, and 72 h after surgery. The time to first flatus passage and the time to first bowel movement also recorded.
Adverse events during and after surgery were recorded including the incidence of postoperative nausea and vomiting, puncture site in⁃
fection, abdominal organ injury, local anesthetic toxicity, hypokinesia of the lower extremity, and paresthesia. All patients were followed
up for one month while the average Visual Analogue Scale (VAS) score in the last week was also recorded. Results Eighty⁃seven of
one hundred patients fulfilled the study protocol. The cumulative morphine dose in the first 24 h in group Q was significantly lower than
the dose in group T (P<0.05). The time of the first requirement for morphine was significantly longer in group Q than in the time group
T. The VAS scores for postoperative visceral pain at rest and on movement in group Q were significantly lower than the scores in group
T at 2,12 h and 24 h respectively (P<0.05). The VAS scores for postoperative incisional pain (at rest) were also low in group Q at 24 h.The time to first flatus passage and the time to first bowel movement of patients who received QLB were also significantly shorter in pa⁃
tients who received TAPB (P<0.05). There was no significant difference between the two groups in other outcomes (P>0.05). Conclusions
Compared with the TAPB, QLB provided better visceral pain relief with a longer duration of effect and accelerated postopera⁃
tive recovery of bowel function in patients under laparoscopic colorectal surgery.
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