The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Postoperative analgesic effects of the quadratus lumborum block in pediatric patients: a systematic review and meta-analysis

  • Insun Park (Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital) ;
  • Jae Hyon Park (Department of Radiology, The Armed Forces Daejeon Hospital) ;
  • Hyun-Jung Shin (Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital) ;
  • Hyo-Seok Na (Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital) ;
  • Bon-Wook Koo (Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital) ;
  • Jung-Hee Ryu (Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital) ;
  • Ah-Young Oh (Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
  • Received : 2023.09.22
  • Accepted : 2023.12.04
  • Published : 2024.01.01
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Abstract

Background: This study assessed the postoperative analgesic efficacy and safety of the quadratus lumborum block (QLB) in pediatric patients. Methods: Electronic databases were searched for studies comparing the QLB to conventional analgesic techniques in pediatric patients. The primary outcome was the need for rescue analgesia 12 and 24 hours after surgery. Secondary outcomes covered the Face-Legs-Activity-Cry-Consolability Scale (FLACC) scores at various time points; parental satisfaction; time to the first rescue analgesia; hospitalization time; block execution time; block failure rates, and adverse events. Results: Sixteen randomized controlled trials were analyzed involving 1,061 patients. The QLB significantly reduced the need for rescue analgesia both at 12 and 24 hours after surgery (12 hours, relative risk [RR]: 0.45; 95% confidence interval [CI]: 0.01, 0.88; 24 hours, RR: 0.51; 95% CI: 0.31, 0.70). In case of 24 hours after surgery, type 1 QLB significantly reduced the need for rescue analgesia (RR: 0.56; 95% CI: 0.36, 0.76). The QLB also exhibited lower FLACC scores at 1 hour (standardized mean difference [SMD]: -0.87; 95% CI: -1.56, -0.18) and 6 hours (SMD: -1.27; 95% CI: -2.33, -0.21) following surgery when compared to non-QLB. Among QLBs, type 2 QLB significantly extended the time until the first rescue analgesia (SMD: 1.25; 95% CI: 0.84, 1.67). No significant differences were observed in terms of parental satisfaction, hospitalization time, block execution time, block failure, or adverse events between QLB and non-QLB groups. Conclusions: The QLB provides non-inferior analgesic efficacy and safety to conventional methods in pediatric patients.

Keywords

References

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