A COMPARATIVE STUDY BETWEEN TRANSMUSCULAR QUADRATUS LUMBORUM BLOCK AND OBLIQUE SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK FOR ANALGESIA FOLLOWING UPPER ABDOMINAL SURGERIES

Document Type : Original Article

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Abstract

Background: Ultrasound (US)-guided transmuscular quadratus lumborum (TQL) block and oblique subcostal transversus abdominis plane (OSTAP) block are components of multimodal analgesia for abdominal surgeries.
The aim of the study is to compare the analgesic efficacy of US-guided TQL block versus US-guided OSTAP block after upper abdominal surgeries.
Methods: This prospective randomized study was conducted on 40 patients scheduled for elective open upper abdominal surgery under general anesthesia. Patients were randomly allocated into2groups; OSTAPGroup (20 patients) received US-guided OSTAP block, and TQL Group (20 patients) received US-guided TQL block. At the end of surgical procedure, while patients were still under general anesthesia, each group received 30 mL bupivacaine 0.25%. Postoperative measurements included pain scores, time to first opioid analgesic request, postoperative total opioid consumption, patient satisfaction, and complications.
Results: Patients of TQL group had statistically significant lower 24 h postoperative total morphine consumption than patients of OSTAP group (13.25±2.88 mg and 20.10±3.21 mg, respectively,P < 0.001), and longer time to first opioid analgesic request (373.25±18.76 min. and 245.75±11.50 min., respectively,P < 0.001). Patients received TQL block had also statistically significant lower postoperative pain scores, less frequent morphine doses, and more patient satisfaction.
Conclusion: US-guided TQL block is more effective postoperative analgesic modality than US-guided OSTAP block in patients undergoing elective open upper abdominal surgery under general anesthesia.

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Zagazig University Medical Journal
Volume 25, Issue 6
November 2019
Pages 898-908

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