Regional analgesic techniques for postoperative pain after kidney transplantation: a systematic review and Bayesian meta-analysis
Authors' conclusion
Quadrtus lumborum and transversus abdominus plane blocks reduce pain and opioid consumption at 24 h, but only the reduction in opioid consumption has a high probability of being clinically important. Certainty of evidence is very low; no technique is preferred, and effects on graft function are unknown.
Study context
- Population
- Adult kidney transplant recipients receiving regional analgesia for postoperative pain
- Participants
- 903 recipients · 14 trials
- Comparison
- Quadratus lumborum (QL) and transversus abdominis plane (TAP) blocks pooled against control; QL vs TAP in network meta-analysis
- Outcome
- Pain
- Follow-up
- Every pooled time point
Methodological detailsBayesian random-effects models with minimal clinically important difference (MCID)-scaled priors, GRADE framework, trial-registry search and network meta-analysis added post hoc
- Bayesian random-effects models with MCID-scaled priors
- GRADE framework
- Trial-registry search and network meta-analysis added post hoc
Pooled result
As reported in the abstract
- Both yielded lower pain at every pooled time point, but no pairwise pain comparison reached 80% probability of exceeding the 1.0 point MCID
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| Opioid consumption · 24 hQL vs control · reduction exceeding the 5 mg MCID with a probability >97% | difference (lower with QL) −15.5 morphine milligram equivalents (95% CrI −23.6 to −6.7) | |
| Opioid consumption · 24 hTAP vs control · reduction exceeding the 5 mg MCID with a probability >97% | difference (lower with TAP) −10.5 morphine milligram equivalents (95% CrI −14.4 to −5.5) | |
| −30−20−10010Difference, morphine milligram equivalents (linear scale) |
Pain or opioid consumption, QL vs TAP (network meta-analysis)
- No difference between QL and TAP blocks in pain or opioid consumption reached 80% probability of exceeding the MCID
- Network meta-analysis added post hoc
Graft function and safety
- Graft function and safety data were too sparse to pool
Unpublished registered trials and certainty of evidence
- Eligible registered trials unpublished
- Twelve
- Certainty of evidence was very low
Original publication
Regional analgesic techniques for postoperative pain after kidney transplantation: a systematic review and Bayesian meta-analysis. Br J Anaesth. Published 27 October 2026. doi:10.
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