Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trial
Abstract Background Clinical evidence revealed patients suffered from moderate to severe pain after renal transplantation. Both quadratus lumborum block (QLB) and erector spinae plane block (ESPB) are effective strategies in perioperative analgesia. This trial aims to detect whether truncal blocks a...
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BMC
2025-07-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-03209-5 |
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| author | Yi An Lixia Li Zhongjia Li Fei Lan Tianlong Wang Tongwen Ou Chuanyu Liang Pei Wang Xuefei Jia Hongyi Song Ke Cui Huifang Luo Lei Zhao |
| author_facet | Yi An Lixia Li Zhongjia Li Fei Lan Tianlong Wang Tongwen Ou Chuanyu Liang Pei Wang Xuefei Jia Hongyi Song Ke Cui Huifang Luo Lei Zhao |
| author_sort | Yi An |
| collection | DOAJ |
| description | Abstract Background Clinical evidence revealed patients suffered from moderate to severe pain after renal transplantation. Both quadratus lumborum block (QLB) and erector spinae plane block (ESPB) are effective strategies in perioperative analgesia. This trial aims to detect whether truncal blocks are utility in alleviating postoperative pain after renal transplantation. Methods Ninety-two patients underwent renal transplantation were recruited and randomized to QLB group, ESPB group and control group (C group). Patients in QLB or ESPB group received 0.5% ropivacaine 30 mL for single injection before surgery respectively and patients in C group did not receive any local anesthetic injection before general anesthesia induction. Postoperative pain intensity was evaluated at 0, 2, 4, 6, 8, 12, 24 and 48 h after surgery in the present study. Intraoperative medication and postoperative complications were also recorded and analyzed. Results The proportion of moderate to severe pain in the first 24 h when moving was lowest in the QLB group (41.9% in QLB group vs. 83.9% in ESPB group vs. 96.7% in C group, P < 0.001). Pain intensity score (NRS) in the QLB group was significantly improved at 0, 2, 4, 6, 8 and 12 h after surgery (P < 0.05). Area under curve (AUCs) of NRS scores were significantly lower in the QLB group than in the ESPB group and C group (P < 0.001). We also observed a reduction of remifentanil consumption in the QLB group than in either the ESPB or C groups (P = 0.008 and P < 0.001, respectively). Conclusions Quadratus lumborum block before surgery more effectively suppressed pain after renal transplantation relative to erector spinae plane block. Trial registration This study was registered on October 2, 2020. ChiCTR2000038803. |
| format | Article |
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| institution | DOAJ |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj-art-c2efa24a55304e76a5504c4e423bb1772025-08-20T03:06:02ZengBMCBMC Anesthesiology1471-22532025-07-012511910.1186/s12871-025-03209-5Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trialYi An0Lixia Li1Zhongjia Li2Fei Lan3Tianlong Wang4Tongwen Ou5Chuanyu Liang6Pei Wang7Xuefei Jia8Hongyi Song9Ke Cui10Huifang Luo11Lei Zhao12Department of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Urology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityAbstract Background Clinical evidence revealed patients suffered from moderate to severe pain after renal transplantation. Both quadratus lumborum block (QLB) and erector spinae plane block (ESPB) are effective strategies in perioperative analgesia. This trial aims to detect whether truncal blocks are utility in alleviating postoperative pain after renal transplantation. Methods Ninety-two patients underwent renal transplantation were recruited and randomized to QLB group, ESPB group and control group (C group). Patients in QLB or ESPB group received 0.5% ropivacaine 30 mL for single injection before surgery respectively and patients in C group did not receive any local anesthetic injection before general anesthesia induction. Postoperative pain intensity was evaluated at 0, 2, 4, 6, 8, 12, 24 and 48 h after surgery in the present study. Intraoperative medication and postoperative complications were also recorded and analyzed. Results The proportion of moderate to severe pain in the first 24 h when moving was lowest in the QLB group (41.9% in QLB group vs. 83.9% in ESPB group vs. 96.7% in C group, P < 0.001). Pain intensity score (NRS) in the QLB group was significantly improved at 0, 2, 4, 6, 8 and 12 h after surgery (P < 0.05). Area under curve (AUCs) of NRS scores were significantly lower in the QLB group than in the ESPB group and C group (P < 0.001). We also observed a reduction of remifentanil consumption in the QLB group than in either the ESPB or C groups (P = 0.008 and P < 0.001, respectively). Conclusions Quadratus lumborum block before surgery more effectively suppressed pain after renal transplantation relative to erector spinae plane block. Trial registration This study was registered on October 2, 2020. ChiCTR2000038803.https://doi.org/10.1186/s12871-025-03209-5Acute painErector spinae plane blockQuadratus lumborum blockRenal transplantationUltrasound-guided |
| spellingShingle | Yi An Lixia Li Zhongjia Li Fei Lan Tianlong Wang Tongwen Ou Chuanyu Liang Pei Wang Xuefei Jia Hongyi Song Ke Cui Huifang Luo Lei Zhao Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trial BMC Anesthesiology Acute pain Erector spinae plane block Quadratus lumborum block Renal transplantation Ultrasound-guided |
| title | Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trial |
| title_full | Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trial |
| title_fullStr | Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trial |
| title_full_unstemmed | Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trial |
| title_short | Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trial |
| title_sort | anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation a randomized controlled trial |
| topic | Acute pain Erector spinae plane block Quadratus lumborum block Renal transplantation Ultrasound-guided |
| url | https://doi.org/10.1186/s12871-025-03209-5 |
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