The efficacy of combined lateral and anterior quadratus lumborum blocks in postoperative pain management following pelvic tumor resection: a randomized controlled trial

作者：Xinrui Yin, Xue Tian, Bingyi Wang, Yi-Jung Yang, Xiaodong Tang, Yi Feng, Luyang Jiang · 发表于：Journal of Orthopaedic Surgery and Research · 年份：2025 · DOI：10.1186/s13018-025-05968-w · 被引用次数：2 · 研究领域：Anesthesia and Pain Management、Pain Management and Opioid Use、Cancer, Stress, Anesthesia, and Immune Response

BACKGROUND: A wide range of pain management techniques have been investigated following pelvic tumor resection and reconstruction surgery; however, the optimal components remain a subject of debate. In this prospective randomized controlled trial, we assessed the postoperative analgesic efficacy of integrating lateral quadratus lumborum block (Lateral-QLB) and anterior quadratus lumborum block (Anterior-QLB) with multimodal analgesia (MMA) regimen, compared to MMA regimen alone, in patients undergoing pelvic tumor resection and reconstruction. METHODS: A total of 56 patients were randomly allocated to either the QLB group (n = 28) or the No Block group (n = 28). The QLB group received an ultrasound-guided Combined quadratus lumborum block (a combination of Lateral-QLB and Anterior-QLB), with 20 mL of 0.375% ropivacaine administered on each approach. The No Block group received standardized multimodal analgesia. Both groups followed an identical postoperative patient-controlled intravenous analgesia protocol. Outcomes included opioid consumption (intravenous morphine milligram equivalents, IV MME) at multiple time points within 48 h postoperatively, time to first opioid request, resting/activity-related pain scores, postoperative neurological assessments (lower extremity motor and sensory function), recovery quality quantified using QoR-15 (Quality of Recovery-15) scores on postoperative days (POD) 1, 2, and 7, and chronic pain prevalence during a 3-month follow-up. RESULTS: T...