Ultrasound-Guided Quadratus Lumborum Block Using Bupivacaine versus Bupivacaine–Magnesium Sulfate as Postoperative Analgesia in Open Appendectomy in Middle Age Group

Abstract Background The QLB is an effective analgesic technique for various abdominal wall incisions. The QLB covers T7 to L1 dermatomes by the spread of LA drugs either into the paravertebral space or in the thoracolumbar plane, through iliohypogastric and ilioinguinal nerves, A and C fiber nociceptors, mechanoreceptors and high-density network of lumbar sympathetic fibers. Objective To assess the analgesic sparing effect of adding magnesium sulfate to Bupivacaine in Quadratus lumborum block in patients undergoing open appendectomy under general anesthesia. Patients and Methods After approval of the anaesthesiology department and scientific and ethical committees, this prospective single blind randomized clinical trial study was conducted in Ain Shams University Hospitals. Sixty patients scheduled for open appendectomy under general anaesthesia were included in this study. Patients were randomized using a random number table and the use of a closed envelopes technique to receive quadratus lumborum either magnesium sulphate and bupivacaine or bupivacaine only, each group constitutes of 30 patients. Results We found that the addition of magnesium sulfate to bupivacaine in QLB in open appendectomy in middle age group provides a prolonged duration of postoperative analgesia, with reduced analgesic requirements, a better quality of analgesia in terms of NRS compared to bupivacaine alone group. Conclusion The addition of magnesium sulfate to Bupivacaine in lateral QLB in open appendectomy surgery provides a prolonged duration of postoperative analgesia, with reduced analgesic requirements, a better quality of analgesia in terms of NRS compared to bupivacaine alone group.