Comparison of Posterior Quadratus Lumborum Block vs Surgical Wound Infiltration in Patients Undergoing Bariatric Sleeve Gastrectomy Surgery

Background: We are studying whether the performance of the posterior quadratus lumborum block (pQLB) will decrease postoperative opioid consumption in patients undergoing laparoscopic sleeve gastrectomy (LSG) compared with surgical wound infiltration with local anesthetic. Methods: This is a single-center, prospective, randomized pilot study. Forty ASA 3 patients with severe obesity undergoing LSG were randomized to receive either the pQLB or surgical wound infiltration of local anesthetics. Major endpoints included postoperative analgesic medications in the pQLB group versus the surgical wound infiltration group, visual analog pain scores (VAS 0–10), postoperative time to first opioid, and incidence of nausea and vomiting. Results: Opioid consumption in morphine equivalents on postoperative days 1 (p = 0.86) and 2 (p = 0.57) was not significantly different between the two groups. However, patients in the pQLB group had significantly lower VAS pain scores on postoperative day 1 (p = 0.003) and postoperative day 2 (p = 0.04) than those who received surgical wound infiltration. Conclusions: This prospective, randomized pilot study shows that the performance of pQLB did not reduce postoperative opioid consumption in patients undergoing LSG. However, patients who received the pQLB had significantly lower postoperative VAS pain scores. Therefore, the performance of pQLB is both feasible and may provide analgesic benefits in patients undergoing LSG.