Ultrasound-guided quadratus lumborum block versus ilioinguinal-iliohypogastric nerve block with wound infiltration for postoperative analgesia in unilateral inguinal surgeries: A randomised controlled trial.

Abstract

Ultrasound (US)-guided quadratus lumborum (QL) block is an abdominal field block that has high efficacy in providing postoperative analgesia for abdominal surgeries. This study was undertaken to compare the US-guided QL block with ilioinguinal-iliohypogastric (IIIH) nerve block and local wound infiltration in unilateral inguinal surgeries, in terms of analgesia and overall patient satisfaction. This randomised controlled trial was conducted in two groups of thirty each. After the completion of surgery under spinal anaesthesia, patients in Group QL received 20 ml of inj. ropivacaine 0.5% while patients in Group IL received 10 ml of inj. ropivacaine 0.5% at the ilioinguinal-iliohypogastric nerve site and 10 ml of inj. ropivacaine 0.5% that was locally infiltrated at the surgical site. Duration of analgesia, Visual Analogue Scale (VAS) score, total requirement of analgesic dosage in the first 24 hours, and patient satisfaction score were compared in both the groups. Statistical analysis was performed using unpaired student's t test and Chi-squared test with IBM SPSS Statistics version 21 software. Duration of analgesia was significantly higher in Group QL (544.83 ± 60.22 min) when compared with Group IL (350.67 ± 67.97 min; P < 0.0001). VAS scores and analgesic requirements were also lower in Group QL. The patient satisfaction score was significantly higher in Group QL (3.93 ± 0.91) when compared to Group IL (3.4 ± 1.0; P < 0.05). US-guided QL block significantly prolongs the duration and quality of postoperative analgesia, thereby reducing analgesic consumption and increasing overall patient satisfaction.