• Zhen Zhang, Hao Kong, Yan Li, Zhen-Zhen Xu, Xue Li, Jia-Hui Ma, and Dong-Xin Wang.
• Department of Anesthesiology, Peking University First Hospital, Beijing, China.
• J Clin Anesth. 2024 Sep 1; 96: 111466111466.

Study ObjectiveWe compared the analgesic effects of erector spinae plane block versus quadratus lumborum block following laparoscopic nephrectomy.DesignA randomized controlled trial.SettingA tertiary hospital in Beijing, China.PatientsPatients scheduled for elective laparoscopic nephrectomy.InterventionsA total of 110 patients were enrolled and randomized to receive either erector spinae plane block (n = 55) or quadratus lumborum block (n = 55) under ultrasound guidance. Patient-controlled sufentanil analgesia was provided after surgery.MeasurementsOur primary outcome was cumulative opioid consumption within 24 h after surgery. Secondary outcomes included postoperative pain intensity, subjective sleep quality, and quality of recovery.Main ResultsAll 110 patients (mean 53 years, 57.3% female) were included in the intention-to-treat analysis. Cumulative sufentanil equivalent within 24 h was lower in patients given erector spinae plane block (median 13 μg, interquartile range 4 to 33) than in those given quadratus lumborum block (median 25 μg, interquartile range 13 to 39; median difference - 8 μg, 95% CI -15 to 0, P = 0.041). Pain intensity (0-10 range where 0 = no pain and 10 = the worst pain) at 2, 6, 12, and 24 h after surgery was lower with erector spinae plane block (at rest: median differences -1 point, all P ≤ 0.009; with movement: median differences -2 to -1 points, all P < 0.001). Subjective sleep quality on the night of surgery (the Richards-Campbell Sleep Questionnaire: 0-100 range, higher score better; median difference 12, 95% CI 2 to 23, P = 0.018) and quality of recovery at 24 h (the Quality of Recovery-15: 0-150 range, higher score better; median difference 8, 95% CI 2 to 15, P = 0.012) were better with erector spinae plane block. No procedure-related adverse events occurred.ConclusionsCompared with quadratus lumborum block, erector spinae plane block provided better analgesia as manifested by lower opioid consumption and pain intensity for up to 24 h after laparoscopic nephrectomy.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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