Abstract

Background: Local anesthetics are commonly used in interfascial plane blocks these days. Quadratus lumborum block (QLB) and transversus abdominis plane block (TAPB) have emerged as an indispensable part of multimodal analgesia for post-operative pain management in abdominal procedures. Ultrasound (US)-guided QLB is a good option to be considered in multimodal analgesia for abdominal surgeries.

Aims and Objectives: Our aim was to compare the efficacy of TAPB and QLB in mitigating post-operative pain. The study’s objectives were to evaluate the extent of use of other analgesics in the post-operative period between TAPB and QLB and to compare the duration of action of TAPB and QLB.

Materials and Methods: Sixty patients aged 18–75 years of American Society of Anesthesiologists physical statuses 1–2 were selected and divided randomly into two groups of 30 each, Group Q and Group T who were administered QLB and TAPB, respectively. Before starting this randomized, double-blinded study, ethics committee sanction, and detailed informed written consent were obtained. US-guided QLB and TAPB were performed on either side in patients planned for lower abdominal procedures under sub-arachnoid block and 20 mL of 0.25% bupivacaine was used. Both groups were compared for hemodynamic parameters. Post-operative pain was assessed using the visual analog scale (VAS) and compared between the two groups. The time to initial rescue analgesic requested and the total amount of rescue analgesic requested were compared between the two groups.

Results: Demographic data of Group Q and Group T were similar. The VAS score was much less in Group Q in comparison with Group T at 12, 24, and 48 h. The time at which the first analgesic demanded was much earlier in Group T compared with Group Q (mean: 40.2 vs. 30.57, P = 0.004). Patients in Group T demanded analgesics much more than patients in Group Q.

Conclusion: The posterior QLB represents a much more efficient regional block as part of multi-modal analgesia in comparison to the posterior TAPB in patients undergoing lower abdominal surgeries. We require more studies to decide the ideal dose and the volume of the drug to be administered.

Key words: Quadratus Lumborum Block; Transversus Abdominis Plane Block; Pain; Lower Abdominal Surgeries