Quadratus Lumborum Block III for Postoperative Pain After Percutaneous Nephrolithotomy

Turk J Anaesthesiol Reanim. 2018 Aug;46(4):272-275. doi: 10.5152/TJAR.2018.92331. Epub 2018 Aug 1.


Objective: An effective pain control is important in early mobilization and returning to normal daily life following percutaneous nephrolithotomy (PCNL) operations. The use of an intraoperative local anaesthetic or postoperative analgesic has been reported for pain control in PCNL. Transmuscular quadratus block (QLB III) is a regional anaesthetic technique applied under ultrasound guidance. The aim of this study was to investigate the effectiveness of QLB III on postoperative pain in PCNL.

Methods: This prospective, randomized, double-blinded study was carried out at the Dr Ersin Arslan Training and Research Hospital between December 2016 and March 2017. The QLB III block was administered to a total of 44 patients who had undergone elective PCNL under spinal anaesthesia. While half of the patients (Group S, n=22) received 0.2 cc kg-1 of 0.9% saline, the other half (Group Q, n=22) received 0.2 mL kg-1 of 0.0125 isobaric bupivacain with QLB III. For all patients, the pain level was measured using the visual analog scale (VAS), and the morphine consumptions through patient-controlled analgesia (PCA) were recorded at the postoperative 4, 8, 12, 24, and 48 hours.

Results: The postoperative VAS was found to be statistically significantly higher at the 8th, 12th, and 24th hour in Group S (p<0.05). The postoperative morphine consumption was determined to be statistically significantly higher at the 4th, 8th, 12th, and 24th hour in Group S (p<0.05).

Conclusion: The QLB III was observed to be effective in pain control and reducing morphine consumption during the postoperative 48 hours follow-up after PCNL.

Keywords: Percutaneous nephrolithotomy; postoperative analgesia; quadratus lumborum block.