Authors: Dupuis M, et al.
Anesthesia & Analgesia. August 29, 2025. doi:10.1213/ANE.0000000000007702
This retrospective observational study from Grenoble University Hospital evaluated whether preoperative low-dose posterior quadratus lumborum block (QLB) reduces opioid consumption after laparoscopic nephrectomy compared to transversus abdominis plane (TAP) block or no locoregional analgesia (LRA). The analysis included 289 patients: 54 received QLB, 33 TAP, and 208 no LRA.
Adjusted results showed that at 24 hours, morphine equivalent use was significantly lower in the QLB group (14.7 mg) compared to both TAP (29.0 mg) and no LRA (19.1 mg). At 8 hours, QLB reduced morphine needs by 12.2 mg versus TAP and 11.4 mg versus no LRA. By 48 hours, these differences were no longer significant. Pain scores, nausea, hypoxia, and PACU stay length did not differ among groups.
What You Should Know
• QLB lowered morphine use at 8 and 24 hours postoperatively, but not at 48 hours.
• TAP block showed no meaningful benefit over no LRA.
• No significant impact on pain scores or recovery parameters was observed.
• Findings align with prior randomized studies supporting QLB efficacy.
• Limitations include retrospective design and potential confounding from analgesic regimen differences.
Practice Implication
Low-dose posterior QLB can modestly reduce early postoperative opioid needs in laparoscopic nephrectomy and may be a preferable option to TAP or no block. However, its depth and contraindication in bleeding disorders should be considered. Future research should assess quality-of-life outcomes and long-term benefits.
References
Dupuis M, et al. Anesth Analg. 2025. doi:10.1213/ANE.0000000000007702
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