Quadratus Lumborum Block versus Transversus Abdominis Plane Block for Laparoscopic Radical Resection for Rectal Cancer

Both transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) can provide effective analgesia for abdominal surgery.

To explore whether there are differences in the effects of TAPB and QLB on the quality of postoperative recovery in patients undergoing laparoscopic radical resection for rectal cancer.

In total, 102 patients undergoing laparoscopic radical resection for rectal cancer were randomly divided into two groups. Bilateral TAPB or QLB was performed using 0.375% ropivacaine after the induction of anesthesia. The15-itemQuality of Recovery (QoR-15) scale was usedto assess the quality of recovery at 24 h postoperatively. Secondary indicators included 24-h postoperative fentanyl consumption, patient-controlled analgesia (PCA), incidence of adverse reactions, numerical rating scale (NRS) at rest and during exercise,and incidence of postoperative complications.

QoR-15 scores were higher in the QLB group than in the TAPB group (115.6±11.3 vs. 99.7±14.2, P<0.05). Moreover, the 24-h sufentanil consumption was less in the QLB group than in the TAPB group (2.4±0.5 vs. 5.5±0.3 μg, P<0.05) after surgery. Time durations to first postoperative PCA compression were 152.1±28.4 and 100.3 ± 22.9 min, respectively (P<0.05). The numbers of PCA compressions within 24 h after surgery were 6.0 (2.0, 8.0) and 9.0 (3.0, 12.0) (P<0.05). There were no differences in secondary outcomes, such as adverse reactions, NRS scores at rest and exercise at 24 h postoperatively, as well as complication rates.

Patients undergoing laparoscopic radical resection for rectal cancer with QLB had a better quality of recovery and better analgesic effects at 24 h postoperatively, compared to TAPB.