Effects of TAP and QLB-1 Blocks on Opioid Consumption

March 20, 2026 updated by: Emine OZCAN, Başakşehir Çam & Sakura City Hospital

A Comparison of the Effects of TAP (Transversus Abdominis Plane) Block and QLB-1 (Lateral Quadratum Lumbarum) Block on Postoperative Pain and Opioid Consumption in Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is associated with less pain than open surgery and a shorter recovery time. While the type of pain experienced after laparoscopy differs from that experienced after laparotomy, it is predominantly parietal pain (originating from the abdominal wall). However, patients also report visceral pain due to pneumoperitoneum. Various analgesic procedures, including nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and regional anesthesia techniques, are employed as part of multimodal analgesia for postoperative pain. Regional anesthesia techniques for abdominal surgery include thoracic epidural analgesia, paravertebral block, and transversus abdominis plane (TAP) block. TAP block, one of the truncal blocks, has been utilized in numerous studies in the literature for the management of postoperative pain following abdominal surgery. TAPB is a nerve block technique that blocks sensory nerves by injecting local anesthetic into the plane between the transverse abdominis and internal oblique muscles. Although TAPB can effectively relieve somatic pain in patients undergoing minimally invasive laparoscopic surgery, it may not be suitable for visceral analgesia. Another truncal block that has gained recent attention is the Quadratus Lumborum Block (QLB). QLB is another nerve block technique that blocks sensory nerves by injecting local anesthetic into the interfascial plane between the quadratus lumborum and psoas muscles. QLB offers several advantages, including the ability to provide both somatic and visceral analgesia. This comprehensive approach can result in more effective postoperative analgesia during laparoscopic surgical procedures. Additionally, the use of TAPB or QLB may reduce opioid consumption, potentially improving analgesia in laparoscopic surgeries. The quadratus lumborum muscle can be blocked in four different ways: lateral, posterior, anterior, and intramuscular. In our study, the lateral quadratus lumborum block was the preferred approach. Opioids are the most commonly used narcotic analgesics for postoperative pain. Patients often require opioids for pain relief in the perioperative period, especially in abdominal surgery. However, the use of opioids can lead to a variety of side effects, including excessive sedation, postoperative nausea and vomiting, urinary retention, constipation, hyperalgesia, respiratory depression and immunosuppression. Opioids may have various effects on immune function, including modulation of cytokines, interaction with immune cells, affecting the neuroendocrine system and vascular permeability. These effects may contribute to postoperative complications such as infections and delayed wound healing due to increased inflammatory response. They may also prolong hospitalization. In order to reduce postoperative opioid consumption and opioid-related side effects, ultrasound-guided trunk block techniques are being developed in abdominal surgeries. Currently, ultrasound-guided multimodal analgesia techniques are widely used. Transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) are effective analgesic methods employed in conjunction with multimodal analgesia techniques during anesthesia. The objective of this study was to compare the effects of TAPB (transversus abdominis plane block) and QLB-1 (lateral quadratus lumborum block), which are frequently used in our clinic, on postoperative pain scores and the need for additional analgesics. Secondary objectives included postoperative opioid consumption, nausea and vomiting, hospital stay, and patient and surgeon satisfaction.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

65

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Başakşehir
      • Istanbul, Başakşehir, Turkey (Türkiye), 34480
        • Başakşehir Çam ve Sakura Şehir Hastanesi

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • - Consenting patients,
  • He's having a laparoscopic cholecystectomy,
  • ASA-I-II,
  • Between the ages of 18 and 64,
  • No history of anticoagulant or antiaggregant drug use,
  • Regional anesthesia is not contraindicated and the anesthesiologist is deemed appropriate for regional anesthesia,
  • Under general anesthesia and undergoing laparoscopic surgery,
  • Oriented and cooperative patients,

Exclusion Criteria:

  • - Patients without consent
  • Regional anesthesia is contraindicated,
  • He's having open abdominal surgery,
  • Not in the appropriate age range,
  • Chronic diseases such as uncontrolled DM and HT,
  • Drug allergy,
  • Taking anticoagulants or antiaggregants,
  • History of chronic analgesic use,
  • Presence of active infection in the area to be blocked,
  • Will not be able to comply with postoperative pain /VAS follow-up,
  • Patients with ASA-IV-V

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: TAP (Transversus Abdominis Plan) Block
A bilateral TAP or QLB-1 block will be performed. This block is a standard procedure in our hospital for the management of postoperative pain.
Procedure: Transversus Abdominis Plan Block (TAPB), Lateral Quadratum Lumborum (QLB-1) Block
Following the acquisition of informed consent prior to surgery, 2 mg of intravenous midazolam will be administered to patients who volunteer. These patients will be monitored in the preoperative preparation room. Bilateral TAP or QLB-1 block will be performed, and this block is routinely applied for postoperative pain in our hospital.
Experimental: QLB-1 (Lateral Quadratum Lumborum ) Block
Investigation of the efficacy of QLB-1 block compared to TAP block.
Procedure: Transversus Abdominis Plan Block (TAPB), Lateral Quadratum Lumborum (QLB-1) Block
Following the acquisition of informed consent prior to surgery, 2 mg of intravenous midazolam will be administered to patients who volunteer. These patients will be monitored in the preoperative preparation room. Bilateral TAP or QLB-1 block will be performed, and this block is routinely applied for postoperative pain in our hospital.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
A comparison of the effects of TAP (Transversus Abdominis Plane) block and QLB-1 (Lateral Quadratum Lumbarum) block and opioid consumption in laparoscopic cholecystectomy.
Time Frame: 02.11.2024 - 02.05.2025 ( 6 months)
Rate of opioid analgesic use mg/kg/day
02.11.2024 - 02.05.2025 ( 6 months)
A comparison of the effects of TAP (Transversus Abdominis Plane) block and QLB-1 (Lateral Quadratum Lumbarum) block on postoperative pain in laparoscopic cholecystectomy.
Time Frame: 02.11.2024 - 02.05.2025 ( 6 months)
Pain Measures VAS (Visual Analog Scale) Minimum: 0- Maximum: 10
02.11.2024 - 02.05.2025 ( 6 months)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Başakşehir Çam & Sakura City Hospital

Investigators

  • Principal Investigator: Emine OZCAN, Başakşehir Çam & Sakura City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 2, 2025

Primary Completion (Actual)

February 10, 2026

Study Completion (Actual)

February 28, 2026

Study Registration Dates

First Submitted

July 1, 2024

First Submitted That Met QC Criteria

October 26, 2024

First Posted (Actual)

October 29, 2024

Study Record Updates

Last Update Posted (Actual)

March 24, 2026

Last Update Submitted That Met QC Criteria

March 20, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • EK3419

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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