Quadratus Lumborum versus Transversus Abdominis Plane Block with Oxycodone or Sufentanil for Recovery Quality After Laparoscopic Gastrointestinal Cancer Surgery: A Factorial Randomized Trial.
4 affiliations
- 1Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
- 2Institute of Anesthesiology, Soochow University, Suzhou, Jiangsu, People's Republic of China.
- 3Department of Anesthesiology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, People's Republic of China.
- 4Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, USA.
Abstract
Quadratus lumborum block (QLB) theoretically provides broader visceral analgesia than transversus abdominis plane block (TAPB), while oxycodone, a dual μ- and κ-opioid receptor agonist, may offer superior visceral pain control compared with sufentanil. We evaluated these two regional techniques and two opioid regimens simultaneously in a factorial design to determine their effects on recovery after laparoscopic gastrointestinal cancer surgery. In this single-center, randomized, 2×2 factorial trial, 120 adults were randomly assigned to bilateral QLB or TAPB (0.375% ropivacaine 20 mL per side) and oxycodone or sufentanil patient-controlled analgesia. All patients received intraoperative dexmedetomidine and flurbiprofen axetil. The primary outcome was 24-h recovery quality (15-item quality of recovery scale; minimal clinically important difference 6 points). Secondary outcomes included recovery quality at 48 and 72 h, visceral and incisional pain, opioid consumption, rescue analgesia, and adverse events. For 24-h recovery quality, no significant interaction was found between block and opioid (P = 0.283); QLB vs TAPB (mean [SD] 102.1 [7.9] vs 102.6 [7.6]; mean difference -0.5, 95% CI -3.3 to 2.4; P = 0.740) and oxycodone vs sufentanil (103.7 [6.9] vs 100.9 [8.3]; mean difference 2.8, 95% CI 0.1 to 5.6; P = 0.045) did not reach the Bonferroni-corrected threshold (P < 0.025) or the 6-point difference. Oxycodone was associated with lower visceral pain scores at 1, 6, 24 and 48 h, lower incisional pain scores at 1 and 6 h, and decreased rescue analgesia use (13.3% vs 29.3%). Other outcomes were comparable. Within comprehensive multimodal analgesia, neither QLB nor oxycodone demonstrated superior recovery compared with TAPB or sufentanil. Exploratory findings of lower postoperative pain and less rescue analgesia with oxycodone should be considered hypothesis-generating. Chinese Clinical Trial Registry (ChiCTR2400080766).
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BibTeX
@article{yang2026quadratus,
title = {{Quadratus Lumborum versus Transversus Abdominis Plane Block with Oxycodone or Sufentanil for Recovery Quality After Laparoscopic Gastrointestinal Cancer Surgery: A Factorial Randomized Trial.}},
author = {Guo-Wang Yang and Xiao-Yang Song and Yu-Fan Yang and Hong Liu and Fu-Hai Ji and Ke Peng},
journal = {Drug design, development and therapy},
year = {2026},
month = oct,
doi = {10.2147/dddt.s641249},
url = {https://europepmc.org/article/MED/42953751},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Quadratus Lumborum versus Transversus Abdominis Plane Block with Oxycodone or Sufentanil for Recovery Quality After Laparoscopic Gastrointestinal Cancer Surgery: A Factorial Randomized Trial.
AU - Guo-Wang Yang
AU - Xiao-Yang Song
AU - Yu-Fan Yang
AU - Hong Liu
AU - Fu-Hai Ji
AU - Ke Peng
PY - 2026
DA - 2026/10/24
JO - Drug design, development and therapy
DO - 10.2147/dddt.s641249
UR - https://europepmc.org/article/MED/42953751
AB - Quadratus lumborum block (QLB) theoretically provides broader visceral analgesia than transversus abdominis plane block (TAPB), while oxycodone, a dual μ- and κ-opioid receptor agonist, may offer superior visceral pain control compared with sufentanil. We evaluated these two regional techniques and two opioid regimens simultaneously in a factorial design to determine their effects on recovery after laparoscopic gastrointestinal cancer surgery. In this single-center, randomized, 2×2 factorial trial, 120 adults were randomly assigned to bilateral QLB or TAPB (0.375% ropivacaine 20 mL per side) and oxycodone or sufentanil patient-controlled analgesia. All patients received intraoperative dexmedetomidine and flurbiprofen axetil. The primary outcome was 24-h recovery quality (15-item quality of recovery scale; minimal clinically important difference 6 points). Secondary outcomes included recovery quality at 48 and 72 h, visceral and incisional pain, opioid consumption, rescue analgesia, and adverse events. For 24-h recovery quality, no significant interaction was found between block and opioid (P = 0.283); QLB vs TAPB (mean [SD] 102.1 [7.9] vs 102.6 [7.6]; mean difference -0.5, 95% CI -3.3 to 2.4; P = 0.740) and oxycodone vs sufentanil (103.7 [6.9] vs 100.9 [8.3]; mean difference 2.8, 95% CI 0.1 to 5.6; P = 0.045) did not reach the Bonferroni-corrected threshold (P < 0.025) or the 6-point difference. Oxycodone was associated with lower visceral pain scores at 1, 6, 24 and 48 h, lower incisional pain scores at 1 and 6 h, and decreased rescue analgesia use (13.3% vs 29.3%). Other outcomes were comparable. Within comprehensive multimodal analgesia, neither QLB nor oxycodone demonstrated superior recovery compared with TAPB or sufentanil. Exploratory findings of lower postoperative pain and less rescue analgesia with oxycodone should be considered hypothesis-generating. Chinese Clinical Trial Registry (ChiCTR2400080766).
SN - 1177-8881
ER -