BACKGROUND Abdominal surgery is common and is associated with severe postoperative pain. The transverse abdominal plane (TAP) block is considered an effective means for pain control in such cases. The quadratus lumborum (QL) block is another option for the management of postoperative pain. The aim of this study was to conduct a meta-analysis and thereby evaluate the efficacy and safety of QL blocks and TAP blocks for pain management after abdominal surgery. METHODS We comprehensively searched PubMed, EMBASE, EBSCO, the Cochrane Library, Web of Science and CNKI for randomized controlled trials (RCTs) that compared QL blocks and TAP blocks for pain management in patients undergoing abdominal surgery. All of the data were screened and evaluated by two researchers. RevMan5.3 was adopted for the meta-analysis. RESULTS A total of 8 RCTs involving 564 patients were included. The meta-analysis showed statistically significant differences between the two groups with respect to postoperative pain scores at 2 h (standardized mean difference [Std.MD] = - 1.76; 95% confidence interval [CI] = - 2.63 to - 0.89; p < .001), 4 h (Std.MD = -0.77; 95% CI = -1.36 to - 0.18; p = .01),6 h (Std.MD = -1.24; 95% CI = -2.31 to - 0.17; p = .02),12 h (Std.MD = -0.70; 95% CI = -1.27 to - 0.13; p = .02) and 24 h (Std.MD = -0.65; 95% CI = -1.29 to - 0.02; p = .04); postoperative morphine consumption at 24 h (Std.MD = -1.39; 95% CI = -1.83 to - 0.95; p < .001); and duration of postoperative analgesia (Std.MD = 2.30; 95% CI = 1.85 to 2.75; p < .001). There was no statistically significant difference between the two groups with regard to the incidence of postoperative nausea and vomiting (PONV) (RR = 0.55;95% CI = 0.27 to 1.14;p = 0.11). CONCLUSION The QL block provides better pain management with less opioid consumption than the TAP block after abdominal surgery. In addition, there are no differences between the TAP block and QL block with respect to PONV.

中文翻译：

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腰腹部四头肌阻滞与腹横肌平面阻滞在接受腹部手术的患者中的术后镇痛作用：随机对照试验的系统评价和荟萃分析。

背景技术腹部手术是常见的并且与严重的术后疼痛有关。在这种情况下，腹横肌（TAP）块被认为是控制疼痛的有效手段。腰方quad肌（QL）块是治疗术后疼痛的另一种选择。这项研究的目的是进行荟萃分析，从而评估QL阻滞剂和TAP阻滞剂治疗腹部手术后疼痛的有效性和安全性。方法我们对PubMed，EMBASE，EBSCO，Cochrane图书馆，Web of Science和CNKI进行了全面搜索，以比较比较QL阻滞和TAP阻滞治疗腹部手术患者的疼痛的随机对照试验（RCT）。两名研究人员筛选并评估了所有数据。Meta分析采用RevMan5.3。结果共纳入8项RCT，涉及564例患者。荟萃分析显示两组在2 h时的疼痛评分在统计学上有显着差异（标准平均差异[Std.MD] =-1.76； 95％置信区间[CI] =-2.63至-0.89； p < .001），4小时（标准MD = -0.77; 95％CI = -1.36至-0.18; p = .01），6小时（标准MD = -1.24; 95％CI = -2.31至-0.17; p = .02），12 h（标准MD = -0.70; 95％CI = -1.27至-0.13; p = .02）和24 h（Std.MD = -0.65; 95％CI = -1.29至- 0.02； p = .04）；术后24小时服用吗啡（标准MD = -1.39; 95％CI = -1.83至-0.95; p <.001）; 和术后镇痛持续时间（标准误差= 2.30； 95％CI = 1.85至2.75； p <0.001）。两组在术后恶心和呕吐（PONV）发生率上无统计学差异（RR = 0.55； 95％CI = 0.27至1.14； p = 0.11）。结论与腹部手术后的TAP阻滞相比，QL阻滞可提供更好的疼痛管理，且阿片类药物的消耗较少。另外，对于PONV，TAP块和QL块之间没有差异。