The Efficacy of Quadratus Lumborum Block in Children with Laparoscopy Assisted Pyeloplasty
Gözen Öksüz1, Ahmet Burak Doğan2
1Department of Anesthesialogy Kahramanmaraş Sütçü Imam University,Kahramanmaraş, Turkey
2Department of Pediatric Surgey Kahramanmaraş Sütçü Imam University,Kahramanmaraş, Turkey
BACKGROUND AND AIM: Laparoscopic surgeries have become the gold standard for many surgical procedures in pediatric patients. The patients having a good condition at the time of postoperative discharge, quick wound healing, fewer complications and less pain are the advantages of laparoscopic surgeries. Although the pain felt at the end of the operation is less compared to open surgeries, multimodal analgesia techniques are still needed to manage postoperative pain. Trunk blocks are included in multimodal analgesia techniques for abdominal surgeries.The quadratus lumborum block (QLB) is a new and effective truncal block used for postoperative analgesia in patients undergoing upper and lower abdominal surgery. We aimed to evaluate and compare efficacy of quadratus lumborum block and wound infiltration with using postoperative Face, Legs, Activity, Cry, and Consolability (FLACC) pain scores and total 24-hour analgesic consumption in pediatric patients who underwent laparoscopic pyeloplasty.
METHODS: After the approval of Clinical Investigations Ethics Committee, patients who underwent laparoscopic-assisted pyeloplasty operation between May 2016 and June 2017 were examinated retrospectively. Patients were divided into 2 groups; QLB group and wound infiltration (WI) group. Patient's FLACC scores at 1st., 6th, 12th and 24th hours, postoperative analgesic doses and complications were evaluated from the patient's records.
RESULTS: A total of 31 patients who underwent lap-assisted pyeloplasty were identified from the records. Of those 31 patients, 14 had QLB and 17 had WI. The demographic characteristics of the patients and operation duration were similar.(p>0,05) FLACC scores on 1st, 6th,12th and 24th hours and postoperative total 24-hour paracetamol consumption was significantly lower in QLB group. (p<0,001) No complications were seen in both groups.
CONCLUSIONS: According to this study, QLB provides longer and more effective postoperative analgesia than WI in pediatric patients with laparoscopic-assisted pyeloplasty.
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