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Purpose <p>Various methods have been formulated to reduce pain and relieve immunosuppression in order to improve prognosis. The current study aimed to evaluate the effect of ultrasound-guided quadratus lumborum block (QLB) on the postoperative analgesia and perioperative cell-mediated immunity in patients underwent laparoscopic radical gastrectomy.</p> Patients and methods <p>A total of 54 patients scheduled for laparoscopic radical gastrectomy were randomly evenly assigned into both groups. The participants in Group Q received US-guided QLB 3 bilaterally with ropivacaine (0.25%, 30&#xa0;mL on each side) before surgery along with GA, and those in Group C received GA without any special treatment. Both groups were given patient-controlled intravenous analgesia postoperatively. The primary outcomes were the T-cell subsets and Natural killer (NK) cell level at 30&#xa0;min before surgery (T0) and at 0, 12, 24, and 48&#xa0;h postoperatively (T1, T2, T3, and T4) were measured. The secondary outcomes were as fellows: the visual analog scale (VAS) pain score (rest and movement) at T1, T2, T3, and T4. In addition, the opioid consumption, and the incidence of postoperative adverse reactions.</p> Results <p>The level of CD3 + , CD4 + T, and natural killer (NK) cells, besides the CD4 + /CD8 + ratio showed less reduction at T1, T2, T3, and T4 in Group Q (<i>P</i> &lt; 0.05). The VAS pain scores (at rest and on movement) were significantly lower in Group Q at T1-T4 (<i>P</i> &lt; 0.05). Opioid consumption and the incidence of adverse reactions were lower in Group Q (<i>P</i> &lt; 0.05).</p> Conclusion <p>For patients undergoing LRG, the ultrasound-guided QLB 3 could alleviate perioperative cell-mediated immunity suppression, improve postoperative analgesia, decrease opioid consumption, and reduce the incidence of adverse reactions.</p> Clinical trial registration number <p>The Chinese Clinical Trial Registry (ChiCTR2000034592).</p> Graphical abstract <p></p>

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Efficacy of quadratus lumborum block type 3 on postoperative cell-mediated immunity and analgesia for laparoscopic radical gastrectomy: a prospective randomized controlled trial

  • 期刊论文

  • 发表日期：

    2025年4月15日

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  • Fuchun Wang,
  • Tian Xie,
  • Yan Guo,
  • Chen Bai,
  • Mingcan Xu,
  • Xiaoyu Wang,
  • Chang Feng

摘要

Purpose

Various methods have been formulated to reduce pain and relieve immunosuppression in order to improve prognosis. The current study aimed to evaluate the effect of ultrasound-guided quadratus lumborum block (QLB) on the postoperative analgesia and perioperative cell-mediated immunity in patients underwent laparoscopic radical gastrectomy.

Patients and methods

A total of 54 patients scheduled for laparoscopic radical gastrectomy were randomly evenly assigned into both groups. The participants in Group Q received US-guided QLB 3 bilaterally with ropivacaine (0.25%, 30 mL on each side) before surgery along with GA, and those in Group C received GA without any special treatment. Both groups were given patient-controlled intravenous analgesia postoperatively. The primary outcomes were the T-cell subsets and Natural killer (NK) cell level at 30 min before surgery (T0) and at 0, 12, 24, and 48 h postoperatively (T1, T2, T3, and T4) were measured. The secondary outcomes were as fellows: the visual analog scale (VAS) pain score (rest and movement) at T1, T2, T3, and T4. In addition, the opioid consumption, and the incidence of postoperative adverse reactions.

Results

The level of CD3 + , CD4 + T, and natural killer (NK) cells, besides the CD4 + /CD8 + ratio showed less reduction at T1, T2, T3, and T4 in Group Q (P < 0.05). The VAS pain scores (at rest and on movement) were significantly lower in Group Q at T1-T4 (P < 0.05). Opioid consumption and the incidence of adverse reactions were lower in Group Q (P < 0.05).

Conclusion

For patients undergoing LRG, the ultrasound-guided QLB 3 could alleviate perioperative cell-mediated immunity suppression, improve postoperative analgesia, decrease opioid consumption, and reduce the incidence of adverse reactions.

Clinical trial registration number

The Chinese Clinical Trial Registry (ChiCTR2000034592).

Graphical abstract