• Qiang Cai, Guoqing Liu, Zengchen Liu, Meiling Gao, Linsheng Huang, Fuhai He, Shangyu Liu, Yunhua Lin, Huixia Wei, Zhiqian Dou, Dexi Liu, Yang Hu, and Xingrui Gong.
• Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
• Pain Pract. 2023 Jan 1; 23 (1): 708270-82.

BackgroundUltrasound-guided quadratus lumborum block (QLB) is considered a novel nerve block for postoperative pain control. However, its efficacy after urological surgery remains unclear.ObjectivesThe purpose of the current meta-analysis was to evaluate the effects of the QLB block versus control (placebo or no injection) on postoperative pain and other adverse outcomes after urological surgery, providing extensive evidence of whether quadratus lumborum block is suitable for pain management after urological surgery.Study DesignSystematic review with meta-analysis of randomized clinical trials.MethodsWe searched PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov to collect studies investigating the effects of QLB on analgesia after urological surgery. The primary outcomes included visual analog scale (VAS) at rest and during movement, 24-h postoperative morphine consumption, and the incidence of postoperative nausea and vomiting (PONV).ResultsOverall, 13 randomized controlled trials (RCTs) were reviewed, including 751 patients who underwent urological surgery. The QLB group exhibited a lower VAS score postoperatively at rest or on movement at 0, 6, 12, and 24 h, with less 24-h postoperative morphine consumption and lower incidence of PONV.LimitationsAlthough the result is stable, heterogeneity exists in the current research.ConclusionsQLB exhibited a favorable effect of postoperative analgesia with reduced postoperative complications at rest or during movement after urological surgery. However, it is still a novel technology at a primary stage, which needs further research to develop.© 2022 World Institute of Pain.

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