Comparative evaluation of ultrasound-guided erector spinae block and quadratus lumborum block for post-operative analgesia in abdominal surgeries

Comparative evaluation of ultrasound-guided erector spinae block and quadratus lumborum block for post-operative analgesia in abdominal surgeries - Background: Midline abdominal surgeries are associated with significant postoperative pain. The introduction of ultrasound-guided techniques has expanded the repertoire of musculo-fascial plane blocks for effective perioperative and postoperative analgesia. This study aimed to compare the analgesic efficacy of ultrasound-guided Quadratus Lumborum Block (QLB) and Erector Spinae Plane Block (ESPB), combined with patient-controlled analgesia (PCA), for pain management following abdominal surgeries with midline incisions. Materials and Methods: In this randomized prospective study, 70 patients were divided into two groups: Group Q (n = 35) received bilateral QLB with 20 mL of 0.375% Ropivacaine, while Group E (n = 35) received bilateral ESPB with the same dosage. Fentanyl PCA was used as analgesic supplement and rescue analgesia was given if NRS ?4. The time of first demand for analgesia, total rescue analgesia consumed over 24 hours and adverse effects were noted. Results: Significant differences in pain scores and analgesic requirements were observed between the two groups. At 0 hours post-surgery, Group Q demonstrated significantly lower mean NRS scores compared to Group E, both for dynamic pain (1.11 vs. 1.54, p = 0.002) and static pain (0.26 vs. 0.94, p < 0 xss=removed xss=removed xss=removed xss=removed> Conclusion: Quadratus Lumborum Block (QLB), when used in conjunction with patient-controlled analgesia (PCA), provides superior pain relief compared to Erector Spinae Plane Block (ESPB), particularly in the immediate postoperative period. Keywords: Analgesia, Ultrasound guided block, Erector Spinae Plane Block, Quadratus lumborum block, Patient-controlled analgesia.