The purpose of this article is to compare the analgesic effects and adverse reactions of ultrasound-guided quadratus lumborum block (QLB) and transverse abdominis plane block (TAPB) in patients undergoing abdominal surgery using meta-analysis. PubMed, Embase, Ovid, Web of Science, Cochrane Library, CNKI, VIP Database, Wanfang Database, and China Biomedical Full text Database were searched using computers. A randomized controlled trial (RCT) was conducted to compare the analgesic effects of QLB and TAPB on the arcuate ligament under ultrasound guidance for abdominal surgery. The main outcome measures were resting state pain scores at 2, 6, 12, 24, and 48 hours postoperatively, and motor state pain scores at 6, 24, and 48 hours postoperatively. The secondary outcome measure is the intraoperative use of sufentanil and remifentanil; The number of cases of rescue analgesia and the number of effective compressions of the analgesic pump within 48 hours after surgery; The incidence of postoperative nausea and vomiting; Hospitalization time. Perform statistical analysis on the data using RevMan 5.4 software. Four RCT studies were included, with a total of 259 cases, including 128 cases in the QLB group (experimental group) guided by ultrasound on the arcuate ligament and 131 cases in the TAPB group (control group) guided by ultrasound. The meta-analysis results showed that compared with the control group, the experimental group had resting state pain scores at 2 hours post surgery (MD=-1.26, 95% CI -1.66-0.87, P<0.0001), resting state pain scores at 6 hours post surgery (MD=-0.3, 95% CI -0.51-0.08, P=0.008), resting state pain scores at 12 hours post surgery (MD=-0.68, 95% CI -0.91-0.45, P<0.0001), and resting state pain scores at 24 hours post surgery (MD=-0.36, 95% CI -0.57-0.16, P=0.0004) The postoperative pain score at 6 hours (MD=-0.31, 95% CI -0.57-0.06, P=0.02), intraoperative sufentanil dosage (MD=-16.46, 95% CI -18.64-14.27, P<0.0001), intraoperative remifentanil dosage (MD=-0.87, 95% CI -0.99-0.75, P<0.0001), and hospital stay (MD=-1.36, 95% CI -1.76-0.96, P<0.0001) were significantly reduced. Two groups of patients had resting state pain scores (MD=-0.09, 95% CI -0.32-0.15, P=0.47), postoperative 24-hour motor state pain scores (MD=-0.22, 95% CI -0.63-0.20, P=0.31), postoperative 48 hour motor state pain scores (MD=-0.20, 95% CI -0.61-0.22, P=0.36), and the number of cases of rescue analgesia at 48 hours after surgery (RR=0.20, 95% CI 0.09-0.44, P<0.0001) There was no statistically significant difference in the number of effective compressions of the analgesic pump 48 hours after surgery (RR=0.15, 95% CI -0.64-0.95, P=0.70) and the incidence of postoperative nausea and vomiting (RR=0.68, 95% CI 0.30-1.52, P=0.35). Existing evidence suggests that ultrasound-guided QLB on the arcuate ligament is more effective than TAPB for postoperative pain relief in abdominal surgery, and does not increase the incidence of adverse reactions.

Huang Xiaoqing, Lian Yu, Dai Xuemei. Meta analysis of ultrasound-guided lumbar quadratus muscle block and transverse abdominis muscle plane block on the arcuate ligament for postoperative pain relief and adverse reactions in abdominal surgery. Frontiers in Medical Science Research (2024), Vol. 6, Issue 4: 1-10. https://doi.org/10.25236/FMSR.2024.060401.

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