Quadratus Lumborum Block for Pain Management After Colorectal Surgery: Systematic Review and Meta-Analysis of Analgesic and Opioid-Sparing Effects.

OBJECTIVE

Quadratus lumborum block (QLB) is an emerging regional anesthesia technique, and its efficacy in colorectal surgery (CRS) remains unclear. This systematic review and meta-analysis aimed to evaluate the effect of QLB on pain control, opioid consumption, and postoperative nausea and vomiting (PONV) after CRS.

METHODS

Relevant articles were acquired from PubMed, Cochrane, Embase, Web of Science, and Scopus from inception to October 9, 2024. The effect of QLB on post-colorectal surgery analgesia, opioid consumption, and secondary outcomes, including time to first analgesic request (TFAR), length of hospital stay (LOS), and PONV, was assessed using mean difference (MD) or relative risk (RR) and corresponding 95% confidence interval (CI).

RESULTS

Six studies involving 465 patients were included. QLB significantly reduced the active visual analogue scale (VAS-A) scores at 12 h (MD = -1.06; 95% CI = -1.89, -0.22; P = 0.014) and 24 h (MD = -0.81; 95% CI = -1.19, -0.43; P = 0.000) after CRS compared to sham or no block. However, QLB did not significantly decrease VAS-A at 48 h, or resting VAS (VAS-R) at 12 h, 24 h, or 48 h after surgery. Additionally, QLB had no impact on opioid consumption at 24 h and 48 h after surgery, overall postoperative opioid consumption, or opioid consumption in PACU. Likewise, QLB did not prolong TFAR, shorten LOS, or reduce the incidence of PONV.

CONCLUSION

QLB effectively relieves active postoperative pain following CRS. While it does not significantly reduce resting pain, opioid consumption, or complications, it has potential benefits in analgesia and recovery.