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KMID : 0356920230760050471
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Korean Journal of Anesthesiology
2023 Volume.76 No. 5 p.471 ~ p.480
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Ultrasound-guided trans-incisional quadratus lumborum block versus ultrasound-guided caudal analgesia in pediatric open renal surgery: a randomized trial
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Amin M. Alansary
Atef Badawy
Marwa A. K. Elbeialy
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Abstract
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Background : The caudal route is a common approach for postoperative analgesia; however, it is associated with limited duration of action. The quadratus lumborum block (QLB) may produce prolonged postoperative analgesia. Therefore, this study aimed to compare the postoperative analgesic efficacy of the ultrasound-guided caudal block with that of the ultrasound-guided transincisional QLB (TiQLB) in pediatric patients undergoing open renal surgery.
Methods : Forty patients of both sexes, aged 2?11 years, were randomly assigned to receive either caudal analgesia with 1.25 ml/kg of bupivacaine 0.2% (Caudal group; n = 20) or a QLB with 0.5 ml/kg of bupivacaine 0.2% (TiQLB group; n = 20) in addition to standard general anesthesia. Time to first analgesia was the primary outcome. Total analgesic consumption in the first 24 h postoperatively, pain scores, and the incidence of side effects were the secondary outcomes.
Results : The mean time to first analgesic requirement was significantly longer in the TiQLB group than in the Caudal group (18.8 ± 5.1 vs. 6.7 ± 0.7 h, P < 0.001). Total ketorolac consumption and pain scores were significantly lower in the TiQLB group (P < 0.001). A few cases of mild postoperative nausea and vomiting were noted among patients in both groups; however, the difference was not statistically significant. No incidence of pruritus, shivering, or respiratory depression was noted.
Conclusions : Analgesia after the ultrasound-guided TiQLB with bupivacaine was superior to that after the ultrasound-guided caudal block, with similar side effects.
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KEYWORD
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Analgesia, Bupivacaine, Interventional ultrasonography, Nerve block, Pediatrics, Postoperative pain
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