Ultrasound guided quadratus lumborum block versus ultrasound guided erector spinae plane block for postoperative analgesia in laparoscopic abdominal surgeries

Abstract

Background: Postoperative pain after laparoscopic abdominal surgeries can be severe. Despite multimodal analgesia protocols, administration of high doses of opioids is often required hindering early mobilization and discharge of the patient from the day surgery setting and is suboptimal in an Early Recovery after Surgery (ERAS) setting. A prospective randomized clinical comparative double blinded study was conducted at Ain Shams University Hospitals.

We evaluated and compared the analgesic effect of ultrasound-guided erector spinae plane (ESP) block with ultrasound-guided posterior Quadratus Lumborum Block (QLB II) in laparoscopic abdominal surgeries.

Methodology: This study was carried on 82 adult patients undergoing laparoscopic surgeries allocated randomly into 2 equal groups ESPB group and QLB II group. The first time to rescue analgesia was reported as a primary outcome. The secondary outcomes include opioid consumption intraoperative, the time of the performance of the block, visual analogue scale (VAS) at rest, at cough and during deep inspiration and total dose of rescue analgesia.

Results: No significant difference recorded between both groups regarding demographic data, first time to rescue analgesia, opioid consumption intraoperative, VAS score and total dose of postoperative analgesia. However, the duration of block procedure was significantly shorter in ESPB group relative to QLB II group (14.2 ± 1.6 min vs 25.3 ± 2.8 min, P < 0.001).

Abbreviations: ERAS: Early Recovery after Surgery, ESP: erector spinae plane, QLB: Quadratus Lumborum Block, VAS: visual analogue scale

Conclusion: Both quadratus lumborum plane block and erector spinae plane block can control postoperative pain after laparoscopic abdominal surgeries; however, erector spinae plane block provided more time saving during its performance.

Keywords: analgesia; ERAS; Erector spinae block; Laparoscopic; Postoperative pain; Quadratus lumborum block; Ultrasound; VAS score

Citation: Boeith AA, Hafez AF, Kamal F, Kamal Eldin DM, Abdelwareth M. Ultrasound guided quadratus lumborum block versus ultrasound guided erector spinae plane block for postoperative analgesia in laparoscopic abdominal surgeries. Anaesth. pain intensive care 2025;29(2):300-306. DOI: 10.35975/apic.v29i2.2592

Received: May 09, 2024; Reviewed: October 26, 2024; Accepted: January 01, 2025