The Effectiveness of Quadratus Lumborum Block Compared to Transversus Abdominis Plane Block in Treating Acute Pain Post Abdominal Surgery: A Systematic Review

Authors

  • Devina Martina Bumi Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Udayana University / Ngoerah Hospital, Denpasar, Indonesia
  • I Gusti Ngurah Mahaalit Aribawa Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Udayana University / Ngoerah Hospital, Denpasar, Indonesia
  • I Made Gede Widnyana Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Udayana University / Ngoerah Hospital, Denpasar, Indonesia
  • Tjokorda Gde Agung Senapathi Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Udayana University / Ngoerah Hospital, Denpasar, Indonesia

DOI:

https://doi.org/10.19166/med.v15i3.11630

Keywords:

quadratus lumborum block, transversus abdominis plane block, pain management, abdominal surgery

Abstract

Background:

Parameters of successful anesthesia and surgery include postoperative pain management. Abdominal surgery can cause severe pain, affect recovery, and trigger pathophysiological reactions. Quadratus lumborum block (QLB) and transversus abdominis plane (TAP) block are commonly used peripheral nerve blocks for postoperative analgesia.

 

Methods:

This systematic review aimed to compare the effectiveness of QLB and TAP block, including postoperative opioid consumption, in adults aged 18 to 65 years undergoing abdominal surgery. The review followed PRISMA guidelines and searched studies assessing QLB and TAP block for acute postoperative pain management.

 

Result:

A total of 475 records were identified, and four randomized controlled trials met the inclusion criteria for further analysis. Outcomes were synthesized descriptively using pain scores (VAS, NPIS, and NRS) and total opioid consumption.

 

Conclusions:

QLB showed more favorable primary and secondary outcomes compared with TAP block in the included studies, suggesting better postoperative analgesic effectiveness after abdominal surgery.

References

1. Bora FA, Dewi DAMS, Kurniyanta IP, Senapathi TGA, Widnyana IMG, Suarjaya PP, et al. The Association Between Preoperative Anxiety and Pain Severity, Opioid Requirement, Neutrophil-to-Lymphocyte Ratio, and Postoperative Blood Glucose After Gynecologic Laparotomy at Ngoerah Hospital. Medicinus. 2026;15(2):75-84. doi:10.19166/med.v15i2.10969.

2. Sudirman T, Wiguna AL. Postoperative Pain Comparison Between Open Hemorrhoidectomy and Stapled Hemorrhoidopexy on Internal Hemorrhoid at Siloam Hospitals Lippo Village. Medicinus. 2023;12(2):141-145. doi:10.19166/med.v10i3.7038.

3. Sudirman T, Kosasih JA. Comparison of Post Operative Pain Score between Doppler-Guided Hemorrhoidal Artery Ligation and Recto Anal Repair with Open Hemorrhoidectomy on Internal Hemorrhoid Grade III-IV at Siloam Hospitals Lippo Village. Medicinus. 2021;11(1):38-43. doi:10.19166/med.v9i2.4701.

4. Sidharta NA, Irawan A, Siregar JI, Lugito NPH. Comparison of Early Postoperative Pain between Lightweight Mesh and Heavyweight Mesh in Lichtenstein Hernia Repair for Geriatric Patients at Rumah Sakit Siloam Karawaci from January 2018-December 2019. Medicinus. 2023;11(3):10-15. doi:10.19166/med.v10i1.6989.

5. Pakardian IA, Dewi DAMS. Anesthetic Management in Obese Patients Undergoing Laparoscopic Cholecystectomy: A Case Report. Medicinus. 2025;14(3):201-212. doi:10.19166/med.v14i3.10152.

6. Tantri IL, Saroso NFDA, Domini MA, Wiwing V. A Case Report: Combined Sciatic Nerve and Lumbar Plexus Nerve Block in a Patient with Acute Decompensated Heart Failure Undergoing Lower Extremity Surgical Debridement. Medicinus. 2023;12(3):30-35. doi:10.19166/med.v11i1.7366.

7. Hermawan GN, Wibisono JJ, Nembo LF. Abdominal Wound Dehiscence: A Review of Risk Factors, Prevention and Management in Obstetrics and Gynecology Practice. Medicinus. 2021;10(2):102-110. doi:10.19166/med.v8i3.3767.

8. Huang I. Addressing Uncontrolled Symptoms and Communication Gaps in a Patient with Metastatic Cholangiocarcinoma: Lessons from a Palliative Care Case. Medicinus. 2025;14(2):150-156. doi:10.19166/med.v14i2.9553.

9. Elsa MC, Sudirman T. Comparison of Post-Operative Pain Score Between Open Appendectomy and Laparoscopic Appendectomy on Acute Appendicitis Patient in Siloam Hospital Lippo Village. Medicinus. 2023;12(3):6-11. doi:10.19166/med.v11i1.7362.

10. Wijaya AA, Deviandry R, Utoyo GA. Acromioclavicular Joint Repair Utilizing a Button Technique for Chronic Instability: A Case Report. Medicinus. 2025;14(3):222-230. doi:10.19166/med.v14i3.10154.

11. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71.

12. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane Handbook for Systematic Reviews of Interventions. 2nd ed. Chichester (UK): John Wiley & Sons; 2019.

13. Deng W, Long X, Li M, Li C, Guo L, Xu G, et al. Quadratus lumborum block versus transversus abdominis plane block for postoperative pain management after laparoscopic colorectal surgery: a randomized controlled trial. Medicine (Baltimore). 2019;98(52):e18448. doi:10.1097/MD.0000000000018448.

14. Kumar GD, Gnanasekar N, Kurhekar P, Prasad TK. A comparative study of transversus abdominis plane block versus quadratus lumborum block for postoperative analgesia following lower abdominal surgeries: a prospective double-blinded study. Anesth Essays Res. 2018;12(4):919-923. doi:10.4103/aer.AER_158_18.

15. Verma K, Malawat A, Jethava D, Jethava DD. Comparison of transversus abdominis plane block and quadratus lumborum block for post-caesarean section analgesia: a randomised clinical trial. Indian J Anaesth. 2019;63(10):820-826. doi:10.4103/ija.IJA_61_19.

16. Yousef NK. Quadratus lumborum block versus transversus abdominis plane block in patients undergoing total abdominal hysterectomy: a randomized prospective controlled trial. Anesth Essays Res. 2018;12(3):742-747. doi:10.4103/aer.AER_108_18.

17. Liu X, Song T, Chen X, Zhang J, Shan C, Chang L, et al. Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol. 2020;20:53. doi:10.1186/s12871-020-00967-2.

18. Elsharkawy H, El-Boghdadly K, Barrington M. Quadratus lumborum block: anatomical concepts, mechanisms, and techniques. Anesthesiology. 2019;130(2):322-335. doi:10.1097/ALN.0000000000002524.

19. Taylor R Jr, Pergolizzi JV, Sinclair A, Raffa RB, Aldington D, Plavin S, Apfel CC. Transversus abdominis block: clinical uses, side effects, and future perspectives. Pain Pract. 2013;13(4):332-344. doi:10.1111/j.1533-2500.2012.00595.x.

20. Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R. The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat. 2012;221(6):507-536. doi:10.1111/j.1469-7580.2012.01511.x.

Downloads

Published

2026-06-25

How to Cite

Bumi, D. M., Aribawa, I. G. N. M., Widnyana, I. M. G., & Senapathi, T. G. A. (2026). The Effectiveness of Quadratus Lumborum Block Compared to Transversus Abdominis Plane Block in Treating Acute Pain Post Abdominal Surgery: A Systematic Review. Medicinus, 15(3), 151–159. https://doi.org/10.19166/med.v15i3.11630

Issue

Section

Clinical Article