ABSTRACT

Quadratus lumborum (QL) block has emerged as a good option to be included in multimodal analgesia for abdominal surgeries. The aim of the present study was to compare the effectiveness of the QL block with the more established transversus abdominis plane (TAP) block along with a control group in terms of duration of analgesia as the primary outcome in total abdominal hysterectomy (TAH).

This randomised, double-blind, controlled trial was performed after ethics committee approval and written informed consent. Ultrasound-guided QL (group Q) and TAP (group T) blocks were administered on either side using 20mL of 0.25% bupivacaine after surgery under general anaesthesia, and group C did not receive any intervention.

There was a significant difference in the duration of analgesia among the groups (P ¼ .00). It was significantly longer in group Q (mean ¼ 8.05 hours; 95% CI, 7.28, 8.81) compared to group T (mean ¼ 5.59 hours; 95% CI, 4.63, 6.45) and group C (mean ¼ 1.19 hours; 95% CI, 1.04, 1.34). The verbal rating score (P ¼ .001) and the cumulative analgesic consumption (P ¼ .00) were the least in group Q. There was no complication in any of the groups. However, the level of satisfaction in patients receiving QL blocks did not differ significantly than in those receiving TAP block.

It is highly recommended to include QL block as a part of multimodal analgesia in TAH as it is superior to TAP block in analgesic effect.

Keywords: Analgesia, pain management, hysterectomy, quadratus lumborum block, transversus abdominis plane block