Ultrasound-Guided Quadratus Lumborum Block Combined with General Anaesthesia or General Anaesthesia Alone for Laparoscopic Radical Gastrectomy for Gastric Adenocarcinoma: A Monocentric Retrospective Study

Abstract

Ran Jiao,1 Shuai Peng,2 Lulu Wang,3 Man Feng,4 Youqin Li,3 Jing Sun,3 Dongyi Liu,5 Jia Fu,5 Chang Feng5 1Hospital of Shandong University, Jinan, 250100, People’s Republic of China; 2Department of Nursing, Yankuang New Journey General Hospital, Zoucheng, 273500, People’s Republic of China; 3Cheeloo College of Medicine, Shandong University, Jinan, 250102, People’s Republic of China; 4Department of Pathology, Affiliated Hospital of Shandong Academy of Medical Sciences, the Third Affiliated of Shandong First Medical University, Jinan, 250000, People’s Republic of China; 5Department of Anaesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, People’s Republic of ChinaCorrespondence: Chang Feng, Department of Anaesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, 247 Bei Yuan Street, Jinan, 250033, People’s Republic of China, Tel [phone], Email [email protected]: To investigate, in patients with gastric carcinoma undergoing laparoscopic radical gastrectomy, the effects of ultrasound-guided quadratus lumborum block (UG-QLB) combined with general anaesthesia (GA) on the postoperative recovery compared with GA alone.Patients and Methods: The retrospective study enrolled 231 patients with gastric carcinoma undergoing laparoscopic radical gastrectomy, including 119 patients who received UG-QLB combined with GA (Group QG), and 112 patients undergoing GA alone (Group GA). The primary endpoint was the postoperative 3-year recurrence-free survival (RFS). The secondary endpoints were the average visual analogue scale (VAS) scores within 48 h after surgery, the first time of postoperative ambulation, the first time of flatus, postoperative hospitalization, perioperative opioid requirement and adverse effects after surgery.Results: UG-QLB combined with GA did not affect the 3-year RFS in patients undergoing laparoscopic radical gastrectomy (HR 0.659, 95% CI 0.342– 1.269, P=0.212). However, the VAS ranking analysis implicated that it could significantly alleviate the postoperative pain in laparoscopic radical gastrectomy patients (P< 0.01). In addition, it dramatically facilitated the early recovery of postoperative ambulation and flatus, while shortening the duration of postoperative hospitalization (P< 0.01). The most important was it could remarkably reduce the opioid consumption (P< 0.01), which in the meanwhile, reduced the incidence of postoperative nausea and vomiting (PONV) (P=0.01).Conclusion: Although UG-QLB combined with GA did not improve the 3-year RFS for patients with gastric carcinoma undergoing laparoscopic radical gastrectomy, it could provide satisfactory postoperative pain relief, reduce opioid consumption and adverse effects, which subsequently facilitates postoperative early rehabilitation.Keywords: gastric adenocarcinoma, prognosis, postoperative early recovery, laparoscopic radical gastrectomy, quadratus lumborum block, ultrasound guidance

Keywords

• gastric adenocarcinoma
• prognosis
• postoperative early recovery
• laparoscopic radical gastrectomy
• quadratus lumborum block
• ultrasound guidance