Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block in Post-Operative Pain Management after Laparoscopic Sleeve Gastrectomy

Abstract Background ultrasound-guided quadratus Lumborum block (QLB) performed as one of the postoperative pain management procedures for patients undergoing abdominal surgeries. Objective The aim of this study is to compare the effect of ultrasound guided bilateral QLB versus bilateral ultrasound guided Transversus abdominis plane (TAP) block on postoperative analgesia in patients undergoing laparoscopic sleeve gastrectomy (LSG) under general anesthesia. Patients and Methods Setting and design: pilot exploratory study conducted on 45 patients scheduled for elective LSG. All patients received general anesthesia using IV fentanyl (1-2 Mg/kg). QLB Group (15 patients): received ultrasound-guided QLB after induction of general anesthesia using 0.2 mL/kg of 0.25% bupivacaine per side. TAP Group (15 patients): received ultrasound-guided TAP block after induction of general anesthesia using 0.2 mL/kg of 0.25% bupivacaine per side. Control Group (15 patients): received general anesthesia and then 1gm IV paracetamol and 30mg IV ketorolac 1 hour and 8 hour postoperative. Results there was statistically significant difference between the three groups as regards the VAS score, total dose of pethidine used postoperatively, number of patients needed rescue analgesia and postoperative hemodynamics; indicating that TAP block was more effective than intravenous drug analgesia, while QLB was more effective than TAP block. Conclusion QLB was the most effective technique in providing analgesia after LSG in comparison to TAP block and intravenous analgesic drugs.