Transplant Trial Watch

Efficacy of ultrasound guided quadratus lumborum block as postoperative analgesia in renal transplantation recipients: A randomised double blind clinical study.

Sindwani, G., et al.

Indian Journal of Anaesthesia 2020; 64(7): 605-610.


Aims
The aim of this study was to investigate the analgesic efficacy of quadratus lumborum block (QLB) for post-operative analgesia in patients undergoing kidney transplantation.

Interventions
Participants were randomly assigned to two groups: the block group, which received 20 ml of 0.25% bupivacaine; and the placebo group, which received 20ml of normal saline.

Participants
60 patients undergoing renal transplantation.

Outcomes
The primary outcome was to compare the total consumption of fentanyl during the first 24 hours post-operation. The secondary outcomes included the comparison of post-operative pain on movement, pain at rest and sedation score after the surgery.

Follow-up
24 hours

CET Conclusions
This is a good quality, randomized and double-blind placebo-controlled trial. It is small in size (30 patients in each arm) but was powered to see a significant reduction in post-operative fentanyl consumption, based upon a pilot study. Renal transplant recipients were randomized to receive a quadratus lumborum block with either bupivacaine or saline. The study found that the bupivacaine quadratus lumborum block was associated with a significant reduction in fentanyl consumption and pain scores over the first 24 hours. Sedation scores and nausea/vomiting symptoms are reported but not statistically tested; they do not appear to be drastically different. There were no incidents of lower limb weakness. The next question must surely be how this technique compares to the more commonly used transversus abdominus plane (TAP) block.

Jadad score
4

Data analysis
Per protocol analysis

Allocation concealment
Yes

Trial registration
CTRI/2017/06/008924

Funding source
Non-industry funded