Work

Anterior quadratus lumborum block at the lateral supra-arcuate ligament versus thoracic paravertebral block for postoperative analgesia after laparoscopic nephrectomy: a randomized non-inferiority trial

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Background This study compared the analgesic effects of the anterior quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) and thoracic paravertebral block (TPVB) for laparoscopic nephrectomy to verify whether the new quadratus lumborum block is an efficient technique for managing laparoscopic nephrectomy pain as an alternative to TPVB.Methods This study was a prospective randomized noninferiority clinical trial. Before general anaesthesia, 80 participating patients were randomly allocated to receive QLB-LSAL (20 mL of 0.5% ropivacaine) or TPVB (20 mL of 0.5% ropivacaine). The primary outcome was the mean visual analogue scale (VAS) score in the first 24-hafter surgery. The secondary outcomes included the cutaneous sensory block area, intraoperative haemodynamic changes, consumption of sufentanil at 24-h postoperatively, and postoperative recovery data.Results The mean VAS score during the first 24-h was 1.92 ± 0.28 in the QLB-LSAL group and 1.79 ± 0.25 in the TPVB group. The mean treatment difference (QLB-LSAL–TPVB) in the primary outcome was 0.13 (95% CI 0.02 to 0.25). The upper limit of the 95% CI remained below the non-inferiority margin. After 10 and 30 min, the TPVB group had significantly greater cutaneous sensory block area (p < 0.001). The consumption of sufentanil at 24-h postoperatively was similar between the two groups (p > 0.05). Neither intraoperative hemodynamic alterations nor postoperative recovery metrics showed significant differences between the two groups (p > 0.05).Conclusions At 24-h postoperatively, QLB-LSAL had analgesic effects that were not inferior to those of TPVB for patients undergoing laparoscopic nephrectomy.Trial registration Chinese Clinical Trial Registry website; registration number: ChiCTR2100048226.

Source: Annals of Medicine

DOI: 10.1080/07853890.2025.2575888