HOME
pISSN 2005-9159
eISSN 2093-0569
eISSN 2093-0569
Korean J Pain 2024; 37(1): 59-72
Published online January 1, 2024 https://doi.org/10.3344/kjp.23268
Copyright © The Korean Pain Society.
Insun Park1 
, Jae Hyon Park2 , Hyun-Jung Shin1 , Hyo-Seok Na1 , Bon-Wook Koo1 , Jung-Hee Ryu1,3 , Ah-Young Oh1,3
1Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
2Department of Radiology, The Armed Forces Daejeon Hospital, Daejeon, Korea
3Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicines, Seoul, Korea
Correspondence to:Ah-Young Oh
Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundanggu, Seongnam 13620, Korea
Tel: +82-31-787-7499, Fax: +82-31-787-4063, E-mail: ohahyoung@hanmail.net
Handling Editor: Hyun Kang
Received: September 22, 2023; Revised: November 22, 2023; Accepted: December 4, 2023
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: This study assessed the postoperative analgesic efficacy and safety of the quadratus lumborum block (QLB) in pediatric patients.
Methods: Electronic databases were searched for studies comparing the QLB to conventional analgesic techniques in pediatric patients. The primary outcome was the need for rescue analgesia 12 and 24 hours after surgery. Secondary outcomes covered the Face-Legs-Activity-Cry-Consolability Scale (FLACC) scores at various time points; parental satisfaction; time to the first rescue analgesia; hospitalization time; block execution time; block failure rates, and adverse events.
Results: Sixteen randomized controlled trials were analyzed involving 1,061 patients. The QLB significantly reduced the need for rescue analgesia both at 12 and 24 hours after surgery (12 hours, relative risk [RR]: 0.45; 95% confidence interval [CI]: 0.01, 0.88; 24 hours, RR: 0.51; 95% CI: 0.31, 0.70). In case of 24 hours after surgery, type 1 QLB significantly reduced the need for rescue analgesia (RR: 0.56; 95% CI: 0.36, 0.76). The QLB also exhibited lower FLACC scores at 1 hour (standardized mean difference [SMD]: –0.87; 95% CI: –1.56, –0.18) and 6 hours (SMD: –1.27; 95% CI: –2.33, –0.21) following surgery when compared to non-QLB. Among QLBs, type 2 QLB significantly extended the time until the first rescue analgesia (SMD: 1.25; 95% CI: 0.84, 1.67). No significant differences were observed in terms of parental satisfaction, hospitalization time, block execution time, block failure, or adverse events between QLB and non-QLB groups.
Conclusions: The QLB provides non-inferior analgesic efficacy and safety to conventional methods in pediatric patients.
Keywords: Analgesia, Meta-Analysis, Nerve Block, Pain, Pain Measurement, Pain, Postoperative, Pediatrics, Systematic Review
