Anesthesiology research and practice · 2026 · 系統性回顧＋統合分析（依標題推測）

Comparative Efficacy of Ultrasound-Guided Quadratus Lumborum Block Versus Alternative Fascial Plane Blocks for Postoperative Analgesia Following Hysterectomy: A Systematic Review and Meta-Analysis.

全身性肌肉骨骼・風濕・疼痛 · 術後疼痛管理

中文閱讀摘要

統合分析顯示，QL阻斷較TAP阻斷能延長首次救護用藥時間並減少24小時鎮痛劑用量，但PONV風險無顯著差異。

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原始摘要

Objective

The primary aim was to compare the efficacy of the quadratus lumborum (QL) block with alternative fascial plane blocks for postoperative analgesia following hysterectomy, while secondary aims were to compare total 24-h analgesic consumption, postoperative pain scores at different time intervals, and the incidence of postoperative nausea and vomiting (PONV) between the QL block and comparator groups.

Methods

Electronic databases were systematically searched for studies that compared bilateral ultrasound-guided single-injection QL block to no block or other fascial plane blocks in hysterectomy surgeries. The QL block was compared with other fascial plane blocks, including transversus abdominis plane (TAP), oblique subcostal TAP (OSTAP), erector spinae plane (ESP), and combined TAP with ilioinguinal/iliohypogastric nerve block. The methodological quality of the included studies was assessed using the RoB 2.0 risk-of-bias tool. All outcomes were pooled using the Mantel-Haenszel method and random-effect model.

Results

After screening 946 relevant articles, 15 RCTs were included in this meta-analysis. The QL block significantly prolonged the time to first rescue analgesic request compared to the TAP block in the abdominal hysterectomy subgroup (MD 244.77 [95% CI: 191.98 to 297.56], I 2 = 89%; GRADE evidence-"high") and the laparoscopic hysterectomy subgroup (MD 443.15 [95% CI: 56.37 to 829.93], I 2 = 98%; GRADE evidence-"high"). Regarding the 24-h total analgesic requirement, the QL block significantly reduced its consumption than the TAP block in both the abdominal (MD -2.64 [95% CI: -4.19 to -1.09], I 2 = 93%; GRADE evidence-"moderate") and the laparoscopic hysterectomy subgroup (MD -6.65 [95% CI: -7.39 to -5.91], I 2 = NA due to n = 1; GRADE evidence-"moderate"). The risk of PONV did not differ significantly between the QL block and placebo in abdominal hysterectomy (RR 2.48 [95% CI: 0.50 to -12.35], I 2 = 0%; GRADE evidence: "moderate") and laparoscopic hysterectomy arm (RR 0.78 [95% CI: 0.50 to -1.22], I 2 = 44%; GRADE evidence: "moderate"). The QL block did not show significant difference in risk of PONV than the TAP block across both the abdominal (RR 0.59 [95% CI: 0.25 to 1.40], I 2 = 0%; GRADE evidence: "moderate") and laparoscopic hysterectomy subgroups (RR 0.86 [95% CI: 0.30 to 2.45], I 2 = 0%; GRADE evidence: "moderate").

Conclusion

The QL block provides superior postoperative analgesia compared with the TAP block in patients undergoing abdominal and laparoscopic hysterectomy.

至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19

書目、來源與全文狀態

DOI: 10.1155/anrp/5760922
PMID／PMCID: 42158239 / PMC13181214
作者: Dwivedi P, Patel TK, Bajpai V, Goyal C, Kabi A, Sharma SK, Joshi HS, Singh P
首次發表日期: 2026-05-17Europe PMC 提供，部分日期可能依年份或月份推定。
卷／期／頁碼或文章編號: 2026 ／期未提供／ 5760922
書目來源與查核日期: Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
全文與授權: 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。來源授權標示：cc by。

可回溯引用

Dwivedi P, Patel TK, Bajpai V, Goyal C, Kabi A, Sharma SK, Joshi HS, Singh P. Comparative Efficacy of Ultrasound-Guided Quadratus Lumborum Block Versus Alternative Fascial Plane Blocks for Postoperative Analgesia Following Hysterectomy: A Systematic Review and Meta-Analysis. Anesthesiology research and practice. 2026;2026:5760922. PMID: 42158239. PMCID: PMC13181214. doi:10.1155/anrp/5760922

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