Utility of Quadratus Lumborum Blocks in Patients Who Undergo Liver Transplant: A Single-Center Retrospective Study

IF 1.9 4区 医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-08-09 DOI:10.1111/ctr.15430
Nicole C. McCoy, Joel M. Sirianni, Joseph Abro, Kaylee Massman, Bethany J. Wolf, William D. Stoll
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Abstract

Background

Regional anesthesia is an alternative to opioids for pain in patients undergoing liver transplantation. Quadratus lumborum blocks may provide appropriate dermatomal coverage with an excellent safety profile.

Methods

Data were collected retrospectively on adult patients who underwent liver transplant at an academic medical center from 2019 to 2022 (n = 207). The primary outcome was opioid administration during the 48 h after transplant.

Results

Patient demographics did not differ between groups. No association was found between patients who received a block and postoperative opioid administration (p = 0.848). However, among patients extubated in the operating room, patients who received a block reported, on average, a 0.9-unit lower pain score than patients who received no block (p = 0.041). Patients who received a block were also more likely to be extubated in the operating room (87.8% block vs. 44.4% no block; p < 0.001).

Conclusion

Patients who underwent liver transplantation had similar postoperative opioid use whether or not they received a quadratus lumborum block. Yet, when evaluating additional factors, such as extubation, pain scores were lower in patients who received a quadratus lumborum block. This important finding supports the idea that quadratus lumborum blocks may be a safe and valuable technique for controlling postoperative pain in adult patients who undergo liver transplantation.

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腰椎四头肌阻滞在肝移植患者中的应用:单中心回顾性研究
背景:区域麻醉是替代阿片类药物治疗肝移植患者疼痛的一种方法。腰椎四头肌阻滞可提供适当的皮区覆盖,且安全性极佳:回顾性收集了2019年至2022年在一家学术医疗中心接受肝移植的成年患者(n = 207)的数据。主要结果是移植后 48 小时内阿片类药物的使用情况:各组患者的人口统计学特征无差异。接受阻滞的患者与术后阿片类药物用量之间没有关联(p = 0.848)。然而,在手术室拔管的患者中,接受阻滞的患者的疼痛评分平均比未接受阻滞的患者低 0.9 个单位(p = 0.041)。接受阻滞的患者也更有可能在手术室拔管(87.8%的患者接受阻滞,44.4%的患者未接受阻滞;p < 0.001):结论:无论是否接受腰椎四头肌阻滞,接受肝移植手术的患者术后使用阿片类药物的情况相似。然而,在评估拔管等其他因素时,接受腰椎四头肌阻滞的患者疼痛评分较低。这一重要发现支持了这样一种观点,即对于接受肝移植手术的成年患者来说,腰椎四头肌阻滞可能是一种安全且有价值的控制术后疼痛的技术。
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来源期刊
Clinical Transplantation
Clinical Transplantation 医学-外科
CiteScore
3.70
自引率
4.80%
发文量
286
审稿时长
2 months
期刊介绍: Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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