Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Laparoscopic Colorectal Surgery: A Systematic Review and Meta-Analysis
Abstract
Background and Objectives: Effective pain control after laparoscopic colorectal surgery is crucial for Enhanced Recovery After Surgery (ERAS) protocols. The transversus abdominis plane block (TAPB) provides somatic analgesia but lacks visceral coverage. The quadratus lumborum block (QLB) has emerged as an alternative, potentially offering both somatic and visceral blockade, but its superiority is debated. This systematic review and meta-analysis aimed to compare the analgesic efficacy of QLB versus TAPB in this setting. Materials and Methods: A comprehensive search of PubMed, Scopus, CENTRAL, and Web of Science was conducted for randomized controlled trials (RCTs) up to November 2025. Primary outcomes were 24 h postoperative and intraoperative opioid consumption. Secondary outcomes included pain scores, length of hospital stay (LoS), surgery duration, and adverse events. Standardized mean differences (SMD) and risk ratios (RR) were pooled. Results: Five RCTs involving 520 patients were included. No significant difference was found in 24 h postoperative opioid consumption (SMD: -1.62, 95% CI [-3.45, 0.20]; p = 0.08) or intraoperative opioid consumption (SMD: 0.38, 95% CI [-0.36, 1.12]; p = 0.31). QLB provided better, transient pain relief at rest at 12 h (SMD: -0.30, 95% CI [-0.52, -0.07]; p = 0.01) and during movement at 6 h (SMD: -0.20, 95% CI [-0.49, -0.09]; p = 0.01). No other time points for pain showed significant differences. QLB was associated with a shorter surgery…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 520 participants or records.
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