{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:58:29Z","timestamp":1790348309626,"version":"4.1.0"},"reference-count":21,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>This study aimed to explore the potential benefits and safety considerations of combining ultrasound-guided quadratus lumborum block (QLB) with low-dose spinal anesthesia (LDSA) versus general anesthesia (GA) for individuals undergoing percutaneous nephrolithotomy (PCNL). This prospective randomized controlled trial included 70 adult patients undergoing PCNL, divided into Group Q (QLB + LDSA, n = 35) and Group G (GA, n = 35). Primary outcomes included postoperative pain, assessed using the Visual Analog Scale (VAS), and opioid consumption, measured by pethidine usage. Secondary outcomes included patient satisfaction, stone clearance rates, hemoglobin and creatinine changes, and adverse events. Multivariate regression analysis identified predictors of outcomes. Postoperative pain scores were significantly lower in Group Q during the first 8 postoperative hours (all p &lt; 0.001). Median pethidine consumption was lower in Group Q (70 mg vs. 105 mg, p &lt; 0.001). Group Q demonstrated superior patient satisfaction, with 82.8% of individuals rating their experience as \"satisfied\" or \"very satisfied,\" markedly exceeding the 8.6% observed in Group G (p &lt; 0.001). Stone clearance outcomes were comparable between the groups, with no statistically significant difference in residual stone burden (p = 0.348). No significant differences were observed in postoperative hemoglobin levels (Group Q: 11.5 \u00b1 0.6 g\/dL vs. Group G: 11.5 \u00b1 0.6 g\/dL, P = 1.0) or serum creatinine levels (Group Q: 1.0 \u00b1 0.2 mg\/dL vs. Group G: 1.0 \u00b1 0.2 mg\/dL, p = 0.611). In PCNL procedures, QLB in conjunction with LDSA demonstrates superior postoperative analgesia, reduced opioid requirements, and improved patient satisfaction while maintaining comparable perioperative and urological outcomes.<\/jats:p>","DOI":"10.4081\/aiua.2026.15857","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:58:51Z","timestamp":1790344731000},"source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and safety of ultrasound-guided quadratus lumborum block combined with low-dose spinal anesthesia &lt;i&gt;versus&lt;\/i&gt; general anesthesia in percutaneous nephrolithotomy: a randomized controlled trial"],"prefix":"10.4081","volume":"98","author":[{"given":"Mohamed Abdelrahman","family":"Alhefnawy","sequence":"first","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Benha University, Benha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Abdelrahman","family":"El-Tawansy","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Helwan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeinab M.","family":"Ewes","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Benha University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem Mohamed","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Urology, The Princess Alexandra Hospital NHS Trust, Harlow, Essex;\u00a0Department of Urology, Southend University Hospital, Mid and South Essex NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Elgammali","sequence":"additional","affiliation":[{"name":"Department of Urology, Wexham Park Hospital, Frimley Health NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Aboulfotouh","family":"El Gharably","sequence":"additional","affiliation":[{"name":"Department of Urology, Southend University Hospital, Mid and South Essex NHS Foundation Trust, United Kingdom;\u00a0 Department of Urology, Kasr Alainy School of Medicine, Cairo University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"253348","doi-asserted-by":"crossref","unstructured":"1. Sun W, Niyazi S, Gao X, et al. Safety and effectiveness of percutaneous nephrolithotomy for patients with stones in a solitary kidney: a meta-analysis. Indian J Surg 2024; 86:39-56.","DOI":"10.1007\/s12262-023-03787-z"},{"key":"253349","doi-asserted-by":"crossref","unstructured":"2. Paneque T, Richey J, Abdelrazek A, et al. Current advances in pain regimens for percutaneous nephrolithotomy: a comprehensive review. Can Urol Assoc J 2023; 17:E388-94.","DOI":"10.5489\/cuaj.8333"},{"key":"253350","doi-asserted-by":"crossref","unstructured":"3. Indra Rachman R, Birowo P, Nurullah G, et al. General versus spinal anesthesia in percutaneous nephrolithotomy: a systematic review and meta-analysis. F1000Res 2023; 12:281.","DOI":"10.12688\/f1000research.124704.2"},{"key":"253351","doi-asserted-by":"crossref","unstructured":"4. Oner S, Onen E, Caglayan V, et al. The effect of anesthesia type on the outcomes of percutaneous nephrolithotomy in elderly males. Ann Med 2023; 55:2238185.","DOI":"10.1080\/07853890.2023.2238185"},{"key":"253352","doi-asserted-by":"crossref","unstructured":"5. Mao Y, Zhao W, Hao M, et al. Ultrasound-guided quadratus lumborum block at the lateral supra-arcuate ligament versus subcostal transversus abdominis plane block for postoperative analgesia following open hepatectomy: a randomized controlled trial. J Pain Res 2023; 16:1429-40.","DOI":"10.2147\/JPR.S404810"},{"key":"253353","doi-asserted-by":"crossref","unstructured":"6. Shukla BB, Malviya D, Kumar S, et al. Comparative evaluation of visual analogue scale and pupillary diameter for post-operative pain: an observational study. Indian J Anaesth 2023; 67:S93-8.","DOI":"10.4103\/ija.ija_1045_21"},{"key":"253354","doi-asserted-by":"crossref","unstructured":"7. Collins K, O'Cathain A. The continuum of patient satisfaction: from satisfied to very satisfied. Soc Sci Med 2003; 57:2465-70.","DOI":"10.1016\/S0277-9536(03)00098-4"},{"key":"253355","doi-asserted-by":"crossref","unstructured":"8. Raman R, Prabha R. Quadratus lumborum block for patients undergoing percutaneous nephrolithotomy: a randomized controlled study. Anesth Essays Res 2021; 15:174-8.","DOI":"10.4103\/aer.aer_92_21"},{"key":"253356","doi-asserted-by":"crossref","unstructured":"9. Blanco R. 271: TAP block under ultrasound guidance: the description of a \u201cno pops\u201d technique. Reg Anesth Pain Med 2007; 32:130.","DOI":"10.1016\/j.rapm.2007.06.268"},{"key":"253357","doi-asserted-by":"crossref","unstructured":"10. Tamura T, Kitamura K, Yokota S, et al. Spread of quadratus lumborum block to the paravertebral space via intramuscular injection: a volunteer study. Reg Anesth Pain Med 2018; 43:372-7.","DOI":"10.1097\/AAP.0000000000000735"},{"key":"253358","doi-asserted-by":"crossref","unstructured":"11. Liao W, Wu X, Yin S, et al. Comparison of postoperative analgesia effects between subcostal anterior quadratus lumborum block and transversus abdominis plane block in bariatric surgery: a prospective randomized controlled study. Trials 2024; 25:522.","DOI":"10.1186\/s13063-024-08359-4"},{"key":"253359","doi-asserted-by":"crossref","unstructured":"12. Chen L, Ji J, Tian Y, et al. Retrospective study of quadratus lumborum block for postoperative analgesia in patients undergoing percutaneous nephrolithotomy. BMC Anesthesiol 2020; 20:217.","DOI":"10.1186\/s12871-020-01134-3"},{"key":"253360","doi-asserted-by":"crossref","unstructured":"13. Abouelgreed TA, Elgarhy AM, Elatreisy A, et al. Is quadratus lumborum block combined with low dose-spinal anesthesia an effective alternative to general anesthesia in patients undergoing percutaneous nephrolithotomy? Arch Ital Urol Androl 2023; 95:11584.","DOI":"10.4081\/aiua.2023.11584"},{"key":"253361","doi-asserted-by":"crossref","unstructured":"14. Turkan H, Kaya C, Turunc E, et al. Effects of anterior quadratus lumborum block versus erector spinae plane block on postoperative acute pain in percutaneous nephrolithotomy: a prospective, observational study. BMC Anesthesiol 2024; 24:322.","DOI":"10.1186\/s12871-024-02691-7"},{"key":"253362","doi-asserted-by":"crossref","unstructured":"15. K\u0131l\u0131\u00e7 E, Bulut E. Quadratus lumborum block III for postoperative pain after percutaneous nephrolithotomy. Turk J Anaesthesiol Reanim 2018; 46:272-5.","DOI":"10.5152\/TJAR.2018.92331"},{"key":"253363","doi-asserted-by":"crossref","unstructured":"16. \u00d6kmen K, Metin \u00d6kmen B, Topal S. Ultrasound-guided posterior quadratus lumborum block for postoperative pain after laparoscopic cholecystectomy: a randomized controlled double blind study. J Clin Anesth 2018; 49:112-7.","DOI":"10.1016\/j.jclinane.2018.06.027"},{"key":"253364","doi-asserted-by":"crossref","unstructured":"17. Peksoz U, Celik M, Alici HA, et al. The effect of transmuscular quadratus lumborum block on postoperative opioid consumption in patients undergoing percutaneous nephrolithotomy: a randomized controlled study. Cureus 2021; 13:e18344.","DOI":"10.7759\/cureus.18344"},{"key":"253365","doi-asserted-by":"crossref","unstructured":"18. Blanco R, Ansari T, Girgis E. Quadratus lumborum block for postoperative pain after caesarean section: a randomised controlled trial. Eur J Anaesthesiol 2015; 32:812-8.","DOI":"10.1097\/EJA.0000000000000299"},{"key":"253366","doi-asserted-by":"crossref","unstructured":"19. Blanco R, Ansari T, Riad W, Shetty N. Quadratus lumborum block versus transversus abdominis plane block for postoperative pain after cesarean delivery: a randomized controlled trial. Reg Anesth Pain Med 2016; 41:757-62.","DOI":"10.1097\/AAP.0000000000000495"},{"key":"253367","doi-asserted-by":"crossref","unstructured":"20. Jin Z, Liu J, Li R, et al. Single injection quadratus lumborum block for postoperative analgesia in adult surgical population: a systematic review and meta-analysis. J Clin Anesth 2020; 62:109715.","DOI":"10.1016\/j.jclinane.2020.109715"},{"key":"253368","doi-asserted-by":"crossref","unstructured":"21. Li Y, Lin C, Liu J. Ultrasound-guided quadratus lumborum block for postoperative analgesia in renal surgery: a systematic review and metaanalysis of randomized controlled trials. J Anesth 2022; 36:254-64.","DOI":"10.1007\/s00540-022-03040-z"}],"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15857\/14521","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15857\/14521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:58:57Z","timestamp":1790344737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/15857"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,25]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2026.15857","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"value":"2282-4197","type":"electronic"},{"value":"1124-3562","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,25]]}}}