• Seungwon Lee, Justin Sangwook Ko, RyungA Kang, Gyu-Seong Choi, KimJong ManJMDepartment of Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea., Mi Sook Gwak, Young Hee Shin, Sangmin Maria Lee, and Gaab Soo Kim.
• Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea.
• J Clin Anesth. 2024 Oct 1; 97: 111504111504.

Study ObjectiveTo determine if single-injection bilateral posterior quadratus lumborum block (QLB) with ropivacaine would improve postoperative analgesia in the first 24 h after laparoscopic hepatectomy, compared with 0.9% saline.DesignProspective, double blinded, randomized controlled trial.SettingA single tertiary care center from November 2021 and January 2023.PatientsA total of 94 patients scheduled to undergo laparoscopic hepatectomy due to hepatocellular carcinoma.InterventionsNinety-four patients were randomized into a QLB group (receiving 20 mL of 0.375% ropivacaine on each side, 150 mg in total) or a control group (receiving 20 mL of 0.9% saline on each side).MeasurementsThe primary outcome was the cumulative opioid consumption during the initial 24-h post-surgery. Secondary outcomes included pain scores and intraoperative and recovery parameters.Main ResultsThe mean cumulative opioid consumption during the initial 24-h post-surgery was 30.8 ± 22.4 mg in the QLB group (n = 46) and 34.0 ± 19.4 mg in the control group (n = 46, mean differences: -3.3 mg, 95% confidence interval, -11.9 to 5.4, p = 0.457). The mean resting pain score at 1 h post-surgery was significantly lower in the QLB group than in the control group (5 [4-6.25] vs. 7 [4.75-8], p = 0.035). No significant intergroup differences were observed in the resting or coughing pain scores at other time points or in other secondary outcomes.ConclusionsPreoperative bilateral posterior QLB did not reduce cumulative opioid consumption during the first 24 h after laparoscopic hepatectomy.Copyright © 2024. Published by Elsevier Inc.

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