Comparative Study between Ultrasound Guided Quadratus Lumborum Block versus Ultrasound Guided Transversus Abdominis Plane Block for Postoperative Pain Relief in Patients Undergoing Unilateral Inguinal Surgeries

Abstract

Background: An effective pain therapy to block or modify the physiologic responses to stress has become an essential component of anesthesia for adequate postoperative pain relief. Objectives: Assessment of the postoperative analgesic efficacy of ultrasound guided quadratus lumborum block compared with transversus abdominis plane block in unilateral inguinal surgeries by measuring total amount of analgesic consumption over 24 hours. Patients and Methods: After approval of scientific and ethical committees in Al-Azhar University Hospitals, ninety patients were included in the study, and were divided into three equal groups: quadratus lumborum block (QLB) group, transversus abdominis plane block (TAP) group and control group. The following data were carried out: vital signs, visual analogue scale, time of first analgesia required by the patient, total amount of analgesia consumption and patient satisfaction score. Results: The QLB was the most effective technique in providing analgesia after unilateral inguinal surgeries without associated hemodynamic instability in comparison to TAP block and intravenous systemic analgesia. TAP block had the ability to provide an intermediate option between intravenous systemic analgesia and QLB when QLB could not be performed. Conclusion: Ultrasound guided quadratus lumborum and transversus abdominis plane blocks provide effective modality for control of postoperative pain associated with unilateral inguinal surgeries with superiority of quadratus lumborum block to transversus abdominis plane block for control of postoperative pain. However, TAP block still technically easier than QL block.