Abstract
To evaluate the effect of quadratus lumborum block (QLB) for postoperative analgesia after percutaneous nephrolithotomy (PCNL), we searched Pubmed, Embase, Cochrane library, the Chinese Biomedical Literature Database, and randomized controlled trials (RCTs) assessing analgesic efficacy of QLB for PCNL are included in this meta-analysis. The related trials met the inclusion criteria were analyzed using RevMan 5.4 software, the weighted mean difference (WMD), with their corresponding 95% CI, was calculated to compare continuous variables. Nine RCTs are included in the meta-analysis showed that QLB group had significantly lower opioids consumption (WMD − 29.59 95% CI − 43.64 to − 15.55; P < 0.00001), lessen visual analog scale (VAS) after surgery 2 h (WMD − 1.35, 95% CI − 1.93 to − 0.76; P < 0.00001), 6 h (WMD − 1.47, 95% CI − 2.04 to − 0.91; P < 0.00001) 12 h (WMD − 1.75, 95% CI − 3.17 to − 0.32; P = 0.02) and 24 h (WMD − 1.4, 95% CI − 1.86 to − 0.94; P < 0.00001), shorter hospital stay(WMD − 0.7, 95% CI -1.26 to − 0.14, P < 0.00001) and reduce intestinal exhaust recovery time (WMD − 7.41, 95% CI − 9.36 to − 5.46, P < 0.00001) than in the control group. QLB offers some potential advantages in terms of opioids consumption, VAS, hospital stay and intestinal exhaust recovery time. However, good quality and large studies with long-term follow-up are warranted for further research.
Similar content being viewed by others
References
Assimos D, Krambeck A, Miller NL et al (2016) Surgical management of stones: Americal urological association/endourological society guidelines, part II. J Urol 196:1161
Alsyouf M, Abourbih S, West B et al (2018) Elevated renal pelvic pressuresduring percutaneous nephrolithotomy risk higher postoperative pain and longer hospital stay. J Urol 199:193–199
Wang J, Zhao C, Zhang C et al (2012) Tubeless vs standard percutaneous nephrolithotomy:a meta-analysis. BJU Int 109:918–924
Blanco R, Ansari T, Girgis E (2015) Quadratus lumborum block for postoperative pain after caesarean section: a randomised controlled trial. Eur J Anaesthesiol 32:812–818
Moher D, Liberati A, Tetzlaff J et al (2009) PRISMA group: preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269
**ao-juan LI, Bo SUN (2022) Effect of general anesthesia combined with quadratus psoas block on postoperative pain sensitivity in patients undergoing percutaneous nephrolithotomy. Jilin Med J 43:44–46
**ng-Da L, Yu-Jian L, Cheng-Yun F (2021) Efficacy and safety of ultrasound-guided quadratus lumborum block in patients receiving percutaneous nephrolithotomy under general anaesthesia. Int J Clin Pract 75(9):e14439
Peksoz U, Celik M, Alici HA et al (2021) The effect of transmuscular quadratus lumborum block on postoperative opioid consumption in patients undergoing percutaneous nephrolithotomy: a randomized controlled study. Cureus 13(9):e18344
Raman R, Prabha R (2021) Quadratus Lumborum block for patients undergoing percutaneous nephrolithotomy: a randomized controlled study. Anesth Essays Res 15(2):174–178
Huang H, Zhuguannan G (2021) Application of quadratus psoas block combined with general anesthesia in percutaneous nephrolithotomy. Shenzhen J Integr Tradit Chinese Western Med 31(2):105–7
Ökmen K, Ökmen BM (2020) Ultrasound-guided anterior quadratus lumborum block for postoperative pain after percutaneous nephrolithotomy: a randomized controlled trial. Korean J Anesthesiol 73(1):44–50
Mette D, Christian KH, Troels DP et al (2019) Transmuscular quadratus lumborum block for percutaneous nephrolithotomy reduces opioid consumption and speeds ambulation and discharge from hospital: a single centre randomised controlled trial. Br J Anaesth 123(2):e350–e358
Yu L, Shen M, Gao B, Zhang G, Zhang ZD (2019) Modifying efficacy of quadratus lumborum block combined with general anesthesiain inpatents undergoing percutaneous nephrolithotomy. Chin J Anesthesiol 39(4):455–457
Kılıç E, Bulut E (2018) Quadratus lumborum block III for postoperative pain after percutaneous nephrolithotomy. Turk J Anaesthesiol Reanim 46(4):272–275
Tüzel E, Kızıltepe G, Akdoğan B (2014) The effect of local anesthetic infiltration around nephrostomy tract on postoperative pain control after percutaneous nephrolithotomy. Urolithiasis 42:353–358
Kirac M, Tepeler A, Bozkurt OF et al (2013) The efficacy of bupivacaine infiltration on the nephrostomy tract in tubeless and standard percutaneous nephrolithotomy: a prospective, randomized, multicenter study. Urology 82:526–531
Honey RJ, Ghiculete D, Ray AA et al (2013) A randomized, double-blinded, placebo-controlled trial of intercostal nerve block after percutaneous nephrolithotomy. J Endourol 27:415–419
Lojanapiwat B, Chureemas T, Kittirattarakarn P (2015) The efficacy of peritubal analgesic infiltration in postoperative pain following percutaneous nephrolithotomy a prospectiverandomized controlled study. Int Braz J Urol 41:945–952
Ak K, Gursoy S, Duger C et al (2013) Thoracic paravertebral block for postoperative pain management in percutaneous nephrolithotomy patients: a randomized controlled clinical trial. Med Principles Pract 22:229–233
Anuradha PB, Anjolie C, Rajeshwari S et al (2014) Analgesic efficacy of paravertebral bupivacaine during percutaneous nephrolithotomy: an observer blinded, randomized controlled trial. J Endourol 28(9):1085–1090
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interests and non-financial support.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Zheng, C., Yang, H., Yang, L. et al. Efficiency and safety of quadratus lumborum block in percutaneous nephrolithotomy: a meta-analysis of randomized controlled studies. Urolithiasis 51, 12 (2023). https://doi.org/10.1007/s00240-022-01381-8
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s00240-022-01381-8