Comparative Study between Ultrasound Guided Quadratus Lumborum Block vs Intraperitoneal and Perioportal Bupivacaine Infiltration as Post Operative Analgesia after Laparoscopic Cholecystectomy

Abstract Background Poorly controlled acute pain after abdominal surgery is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay and an increased likelihood of chronic pain. Objective To test the efficacy of QL block versus intraperitoneal and periportal infiltration with local anesthetic agent in providing postoperative analgesia after laparoscopic cholecystectomy. Patients and Methods Double-blinded randomized controlled clinical study [both the patient and the operator (the surgeon in intraperitoneal and periportal bupivacaine and the anesthetist in QL block) were blinded], After Approval was obtained from the research ethics committee of anesthesia and intensive care department, Ain Shams University. Results The results of the study revealed that the Patients receiving QLB had significantly longer time to first rescue analgesic and significantly lower total opioid consumption in first 24 h post operative compared with patients who received Intraperitoneal and periportal infiltration. Conclusion Bilateral QL block was effective in providing postoperative analgesia (significantly longer time to first rescue analgesia) and reduced postoperative opioid consumption in the first 24-h after laparoscopic cholecystectomy under general anesthesia, compared to intraperitoneal and periportal infiltration. This technique can be a promising mode of postoperative analgesia where epidural catheter insertion is contraindicated.