# Quadratus lumborum block at the lateral supra-arcuate ligament for postoperative analgesia: a protocol for a systematic review and meta-analysis

## TL;DR

This paper outlines a systematic review and meta-analysis protocol to evaluate the effectiveness and safety of a new regional anesthesia technique for postoperative pain.

## Contribution

The study introduces a structured methodology to assess the quadratus lumborum block at the lateral supra-arcuate ligament using updated systematic review guidelines.

## Key findings

- The review will assess opioid consumption and pain scores as primary and secondary outcomes.
- Risk of bias and publication bias will be evaluated using Cochrane and GRADE tools.
- The results aim to guide clinical use of the QLB-LSAL technique for postoperative analgesia.

## Abstract

The quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) is a recent development in the field of regional anaesthetic techniques, offering several advantages over the traditional quadratus lumborum block. However, most current studies on this topic are single-centre and small-sample studies, which may limit the evaluation of the efficacy and safety of this block method.

This protocol adopts the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This evaluation aims to assess the efficacy and safety of QLB-LSAL for postoperative analgesia. The primary outcome is the total consumption of opioid morphine equivalents within 24 h post-surgery. Secondary outcomes comprised numerical rating scale (NRS) pain scores within 24 h postoperatively, Quality of Recovery-15 (QoR-15) scores, patient satisfaction scores, opioid-related side effect incidence and block-related adverse events. This study will only include randomized clinical trials. We will conduct electronic database searches based on the established search strategy. The two review authors will independently screen the literature, extract data and use the Cochrane Risk of Bias 2 tool to assess the risk of bias. We will conduct a meta-analysis on the extracted data and assess the risk of bias for each study. We will also conduct trial sequential analysis, sensitivity analysis and subgroup analysis and assess the overall risk of publication bias. Finally, the GRADE guidelines will be used to assess the certainty of the evidence.

The latest systematic review methodology will be used to assess the efficacy and safety of QLB-LSAL for the treatment of postoperative pain. The findings are expected to provide valuable insights for clinicians to apply QLB-LSAL in the management of postoperative analgesia.