Quadratus lumborum block vs. transversus abdominis plane block for postoperative pain control in patients with nephrectomy: A systematic review and network meta-analysis
Authors' conclusion
QLB is more likely to be effective in reducing postoperative opioid use than TAPB, whereas both of them are superior to control with regard to the reduction in postoperative pain intensity and PONV.
Study context
- Population
- Patients undergoing nephrectomy
- Participants
- 883 patients · 14 studies
- Comparison
- QL block vs TAP block vs control
- Outcome
- Morphine-equivalent consumption
- Follow-up
- 24 h after surgery
Pooled result
As reported in the abstract
Each group vs controlMD (95% CI)P value
QLB
−18.16(−28.96 to −7.37)
P = 0.001TAPB
−8.34(−17.84 to 1.17)
P = 0.09- Network meta-analysis: Quadratus lumborum block (QLB) ranked best for reducing 24 h opioid consumption (p-score)
- 0.854
Further pooled results
| Outcome | MD (95% CI) | P value | |
|---|---|---|---|
| Time to first rescue analgesiaQLB vs Control · direct meta-analysis | 165.00 (128.99–201.01) | P < 0.00001 | |
| Time to first rescue analgesiaTAPB vs Control · direct meta-analysis | 296.82 (−91.92 to 685.55) | P = 0.13 | |
| Postoperative hospital LOSQLB vs Control | −0.29 (−0.49 to −0.08) | P = 0.006 | |
| Postoperative hospital LOSTAPB vs Control | 0.60 (−0.25 to 1.45) | P = 0.17 | |
| −50005001000Difference (linear scale) |
Opioid consumption at other time points
- QLB reduced intraoperative, 6 h and 48 h opioid use; Transversus abdominis plane block (TAPB) reduced opioid use at 6 h only
Postoperative nausea and vomiting (PONV) and pain scores
- Both TAPB and QLB reduced PONV and pain scores vs control at some postoperative time points
Original publication
Quadratus lumborum block vs. transversus abdominis plane block for postoperative pain control in patients with nephrectomy: A systematic review and network meta-analysis. J Clin Anesth. Published 25 March 2024. doi:10.
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