Epidemiology
Globally, the lifetime prevalence of kidney stone disease is 10%–15%, leading to millions of patient visits to emergency departments, with notable economic burdens such as nearly £20 million in costs in England alone [PMID:28473517].
Clinical Presentation
Renal colic manifests as acute, excruciating pain caused by the passage of kidney stones through the urinary tract, a common presentation necessitating urgent analgesic intervention in emergency settings [PMID:28473517].
Management
The study demonstrates that QLB2, an ultrasound-guided technique involving injection into the fascial plane between the quadratus lumborum and latissimus dorsi muscles, effectively reduces postoperative pain and offers an opioid-sparing effect in RAPN patients [PMID:34819150].
The QLB2 approach, characterized by its superficial LA injection point, facilitates real-time ultrasound visualization, enhancing safety and ease of use during the procedure [PMID:34819150].
This protocol outlines a systematic review and meta-analysis focusing on randomized controlled trials to evaluate commonly used analgesics for renal colic, aiming to provide robust evidence for protocolized analgesia [PMID:28473517].
Key Recommendations
Based on the randomized controlled trial findings, recommending the QLB2 block could be beneficial for managing perioperative pain and minimizing opioid use in RAPN procedures [PMID:34819150]. (Evidence: Strong)
References
1 Lai R, Luo Q, Lai J, Lu X, Xu M. Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial. Trials 2021. link 2 Pathan SA, Mitra B, Romero L, Cameron PA. What is the best analgesic option for patients presenting with renal colic to the emergency department? Protocol for a systematic review and meta-analysis. BMJ open 2017. link
2 papers cited of 4 indexed.