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The comparative effectiveness of quadratus lumborum blocks and paravertebral blocks in radical cystectomy patients.

Publication ,  Journal Article
Lee, AJ; Yabes, JG; Hale, N; Hrebinko, RL; Gingrich, JR; Maranchie, JK; Fam, MM; Turner I I, RM; Davies, BJ; Ben-David, B; Jacobs, BL
Published in: Can J Urol
April 2018

INTRODUCTION: Multimodal analgesia is an effective way to control pain and limit opioid use after surgery. The quadratus lumborum block and paravertebral block are two regional anesthesia techniques that leverage multimodal analgesia to improve postoperative pain control. We sought to compare the efficacy of these blocks for pain management following radical cystectomy. MATERIALS AND METHODS: We performed a retrospective review of radical cystectomy patients who received bilateral continuous paravertebral blocks (n = 125) or bilateral single shot quadratus lumborum blocks (n = 50) between 2014-2016. The primary outcome was postoperative opiate consumption on day 0. Secondary outcomes included self-reported pain scores and hospital length of stay. RESULTS: Quadratus lumborum block patients had similar opioid use on postoperative day 0 compared with paravertebral block patients (29 mg versus 30 mg, p = 0.90). Pain scores on postoperative day 0 were similar between quadratus lumborum block and paravertebral block groups (4.0 versus 3.8, p = 0.72); however, the paravertebral block group had lower pain scores on days 1-3 compared with the quadratus lumborum block group (all p < 0.05). Hospital length of stay was similar between groups (6.6 days versus 6.2 days, p = 0.41). CONCLUSIONS: There were no differences in opioid consumption among patients receiving bilateral single shot quadratus lumborum blocks and bilateral continuous paravertebral blocks after radical cystectomy. These data suggest that the quadratus lumborum block is a viable alternative for delivering multimodal analgesia in cystectomy patients.

Duke Scholars

Published In

Can J Urol

ISSN

1195-9479

Publication Date

April 2018

Volume

25

Issue

2

Start / End Page

9255 / 9261.

Location

Canada

Related Subject Headings

  • Urinary Bladder Neoplasms
  • Risk Assessment
  • Retrospective Studies
  • Postoperative Care
  • Pain, Postoperative
  • Pain Measurement
  • Nerve Block
  • Middle Aged
  • Male
  • Humans
 

Citation

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Lee, A. J., Yabes, J. G., Hale, N., Hrebinko, R. L., Gingrich, J. R., Maranchie, J. K., … Jacobs, B. L. (2018). The comparative effectiveness of quadratus lumborum blocks and paravertebral blocks in radical cystectomy patients. Can J Urol, 25(2), 9255-9261.
Lee, Austin J., Jonathan G. Yabes, Nathan Hale, Ronald L. Hrebinko, Jeffrey R. Gingrich, Jodi K. Maranchie, Mina M. Fam, et al. “The comparative effectiveness of quadratus lumborum blocks and paravertebral blocks in radical cystectomy patients.Can J Urol 25, no. 2 (April 2018): 9255-9261.
Lee AJ, Yabes JG, Hale N, Hrebinko RL, Gingrich JR, Maranchie JK, et al. The comparative effectiveness of quadratus lumborum blocks and paravertebral blocks in radical cystectomy patients. Can J Urol. 2018 Apr;25(2):9255-9261.
Lee, Austin J., et al. “The comparative effectiveness of quadratus lumborum blocks and paravertebral blocks in radical cystectomy patients.Can J Urol, vol. 25, no. 2, Apr. 2018, pp. 9255-9261.
Lee AJ, Yabes JG, Hale N, Hrebinko RL, Gingrich JR, Maranchie JK, Fam MM, Turner I I RM, Davies BJ, Ben-David B, Jacobs BL. The comparative effectiveness of quadratus lumborum blocks and paravertebral blocks in radical cystectomy patients. Can J Urol. 2018 Apr;25(2):9255-9261.

Published In

Can J Urol

ISSN

1195-9479

Publication Date

April 2018

Volume

25

Issue

2

Start / End Page

9255 / 9261.

Location

Canada

Related Subject Headings

  • Urinary Bladder Neoplasms
  • Risk Assessment
  • Retrospective Studies
  • Postoperative Care
  • Pain, Postoperative
  • Pain Measurement
  • Nerve Block
  • Middle Aged
  • Male
  • Humans