Comparison of QLB Block and TAP Block in Morbid Obese Patients: A Randomized Controlled Study
Suna Koç, Sevcan Buyuk, Mehmet Alper Ozturk, Mehmet Ilke Buget, Mehmet Dokur
Biruni üniversitesi Tıp Fakültesi
Giriş: Obesity is a global health problem. Bariatric surgery is an effective treatment modality. Postoperative pain management is challenging because of elevated susceptibility to respiratory depression and frequency of obstructive sleep apnea. Transversus abdominis plane(TAP)block and quadratus lumborum block(QLB) have been administered with multimodal analgesia protocols to diminish pain, opioid consumption, nausea&vomiting. Our primary aim was to compare the efficacy of TAP block and QLB-2 block in terms of postoperative pain. The secondary aim was to evaluate postoperative PONV, time to discharge, mobilization and patient satisfaction with World Health Organization quality of life-BREF scale and complications.
Gereç ve Yöntem: Materials and Methods: TAP block applied to Group 1, QLB-2 block applied to Group 2, and no intervention was performed on Group 3 for the control group. Blocks were performed with 0.25% bupivacaine under USG. Patient-controlled analgesia with morphine was administered to all patients. Postoperative 1st,6th,12th and 24th hours and total morphine consumption were assessed. VAS used for measuring pain. Quality of life was evaluated at preoperative, postoperative 48th hours and 1-week times by using WHOQOL-BREF scale. Discharge times between groups, postoperative nausea, vomiting, allergies, nerve damage and bleeding were also recorded
Bulgular: We included 126 cases for the final analysis and found improved results for TAP block. Linear regression analysis revealed diminished total morphine consumption, VAS scores and morphine consumption at the 1st, 6th, 12th hours and block time. The OR for total morphine was -0.0.42(CI:-0.058,-0.026,p<0.001).Regarding VAS scores, significant correlations were observed at the 1st 6th, 12th, 24th, hours(p<0.001). Block time was lower in TAP group (OR:0.133 CI:0.109, 0.156, p<0.001).
Tartışma ve Sonuç: In this study we have reported significantly improved results for TAP block when we compared with QLB-2 block in terms VAS and morphine consumption and block time. We also defined faster block time for TAP blocks with similar side effects
|