A Comparative Study between the Efficacy of Ultrasound Guided Erector Spinae versus Quadratus Lumborum Plane Blocks in Laparoscopic Appendectomy

Abstract Background Laparoscopic appendectomy is more superior to open appendectomy in terms of wound site infections and pain intensity. Although the laparoscopic technique is minimally invasive, postoperative pain is inevitable, and it may affect the patients’ mobility and cause them to stay in the hospital for a more extended period. Aim of the Work to compare the effectiveness of erector spinae plane block and quadratus lumborum plane block as part of multimodal analgesia for reducing postoperative pain in patients undergoing laparoscopic appendectomy. Patients and Methods This prospective randomized controlled clinical trial was conducted at operative theatres, Anesthesiology, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University Hospitals from April until September 2023. Results During this study, 54 patients undergoing laparoscopic appendectomy were enrolled and divided into two equal groups; group A subjected to erector spinae block and group B subjected to quadratus lumborum block. Intraoperative, Post Anaesthesia Care Unit and postoperative haemodynamic, postoperative NRS score, first time of postoperative analgesic request, total amount of postoperative analgesia and serum cortisol levels were measured. In this study there was a significant difference between the two groups regarding NRS scores and total amount of analgesia needed post operatively. In this study, no statistically significant difference was observed between the two groups in terms of serum cortisol levels. In this study, no significant difference was found between the two groups regarding heart rate and mean arterial pressure. Conclusion Both QLB and ESPB are effective as post-operative analgesia techniques for laparoscopic appendectomy. However, our study showed that US-guided ESPB may provide better pain control than QLB. These results allows healthcare providers and patients to choose the most suitable technique based on individual preferences and clinical considerations. However, further research with larger sample sizes and multicentric studies would be valuable to confirm these findings and explore potential variations in different patient populations or surgical settings.