Quadratus lumborum block at the lateral supra-arcuate ligament for postoperative analgesia: a protocol for a systematic review and meta-analysis.

BACKGROUND

The quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) is a recent development in the field of regional anaesthetic techniques, offering several advantages over the traditional quadratus lumborum block. However, most current studies on this topic are single-centre and small-sample studies, which may limit the evaluation of the efficacy and safety of this block method.

METHODS

This protocol adopts the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This evaluation aims to assess the efficacy and safety of QLB-LSAL for postoperative analgesia. The primary outcome is the total consumption of opioid morphine equivalents within 24 h post-surgery. Secondary outcomes comprised numerical rating scale (NRS) pain scores within 24 h postoperatively, Quality of Recovery-15 (QoR-15) scores, patient satisfaction scores, opioid-related side effect incidence and block-related adverse events. This study will only include randomized clinical trials. We will conduct electronic database searches based on the established search strategy. The two review authors will independently screen the literature, extract data and use the Cochrane Risk of Bias 2 tool to assess the risk of bias. We will conduct a meta-analysis on the extracted data and assess the risk of bias for each study. We will also conduct trial sequential analysis, sensitivity analysis and subgroup analysis and assess the overall risk of publication bias. Finally, the GRADE guidelines will be used to assess the certainty of the evidence.

DISCUSSION: The latest systematic review methodology will be used to assess the efficacy and safety of QLB-LSAL for the treatment of postoperative pain. The findings are expected to provide valuable insights for clinicians to apply QLB-LSAL in the management of postoperative analgesia.