Comparing the Post-operative Analgesic Effects of Ultrasound-Guided Bilateral Quadratus Lumborum Block Using Ropivacaine versus Bupivacaine in Laparoscopic Appendectomy Surgeries: A Randomized Controlled Clinical Study

Abstract Background and Aims: Comparing local anesthetics, ropivacaine (0.375%) and bupivacaine (0.25%; 20 mL on each side), in ultrasound sonography (USG)-guided posterior bilateral quadratus lumborum (QL) block (seldomly done before) for total duration of post-operative analgesia, rescue analgesic consumption, and patient satisfaction in laparoscopic appendectomy surgeries. Materials and Methods: A prospective double-blind study, randomly allocated sample size of 25 (American society of anesthesiologists [ASA] I and II patients) each for the two study drugs Inj. ropivacaine 0.375% (Group R) and Inj. bupivacaine 0.25% (Group B) in laparoscopic appendectomy surgeries under conventional general anesthesia. USG-guided bilateral posterior QL block given post-operatively before extubation (T0). Patients evaluated post-operatively for total duration of analgesia (Visual Analog Score [VAS] at rest—static VAS and with activity 4 h after surgery—Dynamic VAS) at various intervals 30 min, 1st, 2nd, 4th, 6th, 12th, 15th hours, and every hourly till VAS > 4 along with hemodynamics and side effect profile. Result: Post operative pain (static and dynamic VAS) evaluated at predetermined time intervals. All patients given rescue analgesia of Inj. tramadol 100 mg intravenously (when VAS > 4) between 15 and 20 h in group R and between 16 and 22 h in group B. The difference was not statistically significant ( P > 0.6). Hemodynamics and side effect profile were not deranged at any juncture. Conclusion: When used in equipotent doses in QL block, both inj. ropivacaine and Inj. bupivacaine provide satisfactory analgesia equivocally for a period of more than 16–20 h post operatively reducing the requirements of systemic analgesics significantly.