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Transversus abdominis plane block vs quadratus lumborum block for postoperative analgesia in inguinal hernia repair: A systematic review and meta-analysis

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Abstract

Purpose

The present review was designed to differentiate between the analgesic value of transversus abdominis plane block (TAP) vs the quadratus lumborum block (QLB) for patients undergoing inguinal hernia surgery.

Methods

PubMed, CENTRAL, Scopus, Embase, Google Scholar, Open gray, and a clinical trial registry were searched up to 18th February 2023 for randomized controlled trials (RCTs) comparing TAP and QLB for inguinal hernia repair.

Results

Six RCTs from India, Turkey, and Norway published between the years 2019 to 2023 were included. Anesthetic agents and dosages were similar for TAP and QLB groups in each study. On meta-analysis, pain scores were not statistically significant different between TAP and QLB at 3–6 h (MD: 0.46 95% CI: -0.11, 1.03 I2 = 86%), 12 h (MD: 1.34 95% CI: -0.12, 2.80 I2 = 97%), and 24 h (MD: 0.38 95% CI: -0.77, 1.53 I2 = 97%). Meta-analysis of total analgesic consumption showed a tendency of reduced analgesic consumption with QLB as compared to TAP but the difference was not significant (SMD: 0.69 95% CI: 0.00, 1.37 I2 = 83%). Data on complications was scarcely available. GRADE assessment of the evidence was low to moderate.

Conclusion

Low to moderate-quality preliminary evidence suggests no difference in the analgesic efficacy of TAP and QLB for adult patients undergoing inguinal hernia repair. While there was a tendency for lower postoperative analgesic consumption with QLB, it needs to be verified by future studies.

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Funding

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Authors and Affiliations

  1. Department of Anesthesiology, Shaoxing Maternity and Child Health Care Hospital, Shaoxing, China

    Liqing Gao & Jielan Ding

  2. Department of Anesthesiology, Shaoxing People’s Hospital, Shaoxing, China

    Kai Xie

  3. Department of Vascular Hernia Surgery, Shaoxing People’s Hospital, 568 Zhongxing North Road, Shaoxing, Zhejiang, China

    Gan Jin

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Contributions

Study Conception and design: LG, KX; Acquisition of data: JD, GJ; Analysis and interpretation of data: LG, KX, GJ; Drafting of manuscript: All authors; Critical revision of manuscript: All authors.

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Correspondence to Gan Jin.

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Gao, L., Xie, K., Ding, J. et al. Transversus abdominis plane block vs quadratus lumborum block for postoperative analgesia in inguinal hernia repair: A systematic review and meta-analysis. Langenbecks Arch Surg 408, 411 (2023). https://doi.org/10.1007/s00423-023-03149-z

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