Quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy: surgical and oncological outcomes of a randomised clinical trial
Objective: The current lack of standardised perioperative pain management protocols for open radical cystectomy (ORC) underscores the need for alternative approaches to the longstanding tradition of epidural block. The aim of this study was to assess the impact of bilateral single injection quadrat...
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Medical journals sweden AB
2025-03-01
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| Series: | Scandinavian Journal of Urology |
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| Online Access: | https://medicaljournalssweden.se/SJU/article/view/43105 |
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| author | Erik Veskimäe Andrus Korgvee Heini Huhtala Heikki Koskinen Maija-Liisa Kalliomaki Teuvo Tammela Eija Junttila |
| author_facet | Erik Veskimäe Andrus Korgvee Heini Huhtala Heikki Koskinen Maija-Liisa Kalliomaki Teuvo Tammela Eija Junttila |
| author_sort | Erik Veskimäe |
| collection | DOAJ |
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Objective: The current lack of standardised perioperative pain management protocols for open radical cystectomy (ORC) underscores the need for alternative approaches to the longstanding tradition of epidural block. The aim of this study was to assess the impact of bilateral single injection quadratum lumborum block (QLB) on patients’ recovery and complication rates compared with epidural analgesia after ORC in a single-centre, randomised, parallel-group trial including adult patients with bladder cancer.
Material and methods: Consecutive ORC patients were randomly allocated into QLB and the epidural group. The primary endpoint of this study was related to opioid consumption, and the results have been published earlier. This report focuses on secondary outcomes.
Results: This study included a total of 41 patients, with 20 patients in the QLB group and 21 patients in the epidural group. Finally, 39 patients were included in the analysis.
There was a trend for more frequent need for postoperative norepinephrine and fluid support in the epidural group but without statistical significance. Postoperative complication rate was similar. Two patients in the epidural group compared to none in the QLB group were rehospitalised within 30 and 90 days. Mortality rate within 90 days was higher in the epidural group (4 vs. 0 patients, P = 0.064).
Conclusions: In this trial, there were no significant differences in surgical and oncological outcomes after ORC when QLB is compared with epidural block for postoperative analgesia.
Trial registration: ClinicalTrials.gov Identifier: NCT03328988
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| format | Article |
| id | doaj-art-eae93783c3f14155af86c2820ccbbfe7 |
| institution | DOAJ |
| issn | 2168-1813 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Medical journals sweden AB |
| record_format | Article |
| series | Scandinavian Journal of Urology |
| spelling | doaj-art-eae93783c3f14155af86c2820ccbbfe72025-08-20T03:13:04ZengMedical journals sweden ABScandinavian Journal of Urology2168-18132025-03-016010.2340/sju.v60.43105Quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy: surgical and oncological outcomes of a randomised clinical trialErik Veskimäe0Andrus Korgvee1Heini Huhtala2Heikki Koskinen3Maija-Liisa Kalliomaki4Teuvo Tammela5Eija Junttila6Department of Urology, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Anaesthesia, Tampere University Hospital, Tampere, FinlandFaculty of Social Sciences, Tampere University, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Anaesthesia, Tampere University Hospital, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Anaesthesia, Tampere University Hospital, Tampere, FinlandDepartment of Urology, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Anaesthesia, Tampere University Hospital, Tampere, Finland Objective: The current lack of standardised perioperative pain management protocols for open radical cystectomy (ORC) underscores the need for alternative approaches to the longstanding tradition of epidural block. The aim of this study was to assess the impact of bilateral single injection quadratum lumborum block (QLB) on patients’ recovery and complication rates compared with epidural analgesia after ORC in a single-centre, randomised, parallel-group trial including adult patients with bladder cancer. Material and methods: Consecutive ORC patients were randomly allocated into QLB and the epidural group. The primary endpoint of this study was related to opioid consumption, and the results have been published earlier. This report focuses on secondary outcomes. Results: This study included a total of 41 patients, with 20 patients in the QLB group and 21 patients in the epidural group. Finally, 39 patients were included in the analysis. There was a trend for more frequent need for postoperative norepinephrine and fluid support in the epidural group but without statistical significance. Postoperative complication rate was similar. Two patients in the epidural group compared to none in the QLB group were rehospitalised within 30 and 90 days. Mortality rate within 90 days was higher in the epidural group (4 vs. 0 patients, P = 0.064). Conclusions: In this trial, there were no significant differences in surgical and oncological outcomes after ORC when QLB is compared with epidural block for postoperative analgesia. Trial registration: ClinicalTrials.gov Identifier: NCT03328988 https://medicaljournalssweden.se/SJU/article/view/43105Bladder cancerradical cystectomyepidural analgesiaquadratum lumborum block |
| spellingShingle | Erik Veskimäe Andrus Korgvee Heini Huhtala Heikki Koskinen Maija-Liisa Kalliomaki Teuvo Tammela Eija Junttila Quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy: surgical and oncological outcomes of a randomised clinical trial Scandinavian Journal of Urology Bladder cancer radical cystectomy epidural analgesia quadratum lumborum block |
| title | Quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy: surgical and oncological outcomes of a randomised clinical trial |
| title_full | Quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy: surgical and oncological outcomes of a randomised clinical trial |
| title_fullStr | Quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy: surgical and oncological outcomes of a randomised clinical trial |
| title_full_unstemmed | Quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy: surgical and oncological outcomes of a randomised clinical trial |
| title_short | Quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy: surgical and oncological outcomes of a randomised clinical trial |
| title_sort | quadratus lumborum block is feasible alternative to epidural block for postoperative analgesia after open radical cystectomy surgical and oncological outcomes of a randomised clinical trial |
| topic | Bladder cancer radical cystectomy epidural analgesia quadratum lumborum block |
| url | https://medicaljournalssweden.se/SJU/article/view/43105 |
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