Pre-emptive analgesic effect of ultrasound-guided quadratus lumborum block versus transversus abdominis plane block in laparoscopic cholecystectomy

Abstract

Background Transversus abdominis plane (TAP) block creates satisfactory somatic analgesia at T6–L1 with minimal or no visceral blockade, whereas quadratus lumborum block (QLB) provides somatic and visceral analgesia of the whole abdomen. Aim To compare the efficacy of QLB with TAP block in controlling pain after laparoscopic cholecystectomy. Patients and methods A total of 70 patients with American Society of Anesthesiologists I and II, aged 18–50 years, who underwent elective laparoscopic cholecystectomy were allocated into two groups: group I (subcostal TAP block) and group II (lateral QLB). Results Pain scores were lower in group II compared with group I at 4, 6, 8, and 10 h postoperatively. The time of first rescue analgesia was prolonged in group II in comparison with group I. Heart rate and mean arterial pressure showed insignificant differences between the two groups intraoperatively. However, there was a significant decrease in heart rate and mean arterial pressure in group II compared with group I at 4, 6, 8, and 10 h postoperatively. There was no reported local anesthetic toxicity or technique-related complication in the two groups. Conclusion Bilateral ultrasound-guided QLB was more effective than bilateral ultrasound-guided subcostal TAP block in patients undergoing laparoscopic cholecystectomy with prolonged postoperative analgesia and less pethidine consumption.