Comparison of the Analgesic Effect and Recovery Quality Between Erector Spinae Plane Block and Quadratus Lumborum Plane Block in Laparoscopic Cholecystectomy: A Retrospective Study

Background: Laparoscopic cholecystectomy (LC) is a common procedure for treating gallbladder diseases, and effective postoperative pain control is essential for improving recovery quality. Erector spinae plane block (ESPB) and quadratus lumborum plane block (QLB) are two regional anesthesia techniques used for pain management in abdominal surgeries. However, a direct comparison of these techniques for pain control and recovery quality in LC is limited. Methods: This retrospective study analyzed 301 patients who underwent LC between January 2021 and December 2022. Patients were assigned to either the ESPB group (n=135) or QLB group (n=166) based on the regional anesthesia technique received. The primary outcomes included postoperative pain scores (measured using the Visual Analog Scale, VAS) and recovery quality (measured using the Quality of Recovery-40 (QoR-40) questionnaire). Secondary outcomes included opioid consumption, time to first ambulation, length of hospital stay, and incidence of complications such as aspiration pneumonia. Results: The QLB group showed significantly lower pain scores at 6, 12, and 24 hours postoperatively compared to the ESPB group (P< 0.05). Furthermore, the QLB group had superior QoR-40 scores, indicating better overall recovery, including physical, emotional, and functional domains (P< 0.001). The total opioid consumption was significantly reduced in the QLB group (P< 0.001). Additionally, patients in the QLB group had a shorter time to first ambulation and a reduced length of hospital stay. No significant differences in postoperative complications were observed between the two groups. Conclusion: QLB provides better analgesic effects and improved recovery quality compared to ESPB in patients undergoing laparoscopic cholecystectomy. This suggests that QLB may be a more effective option for postoperative pain management and faster recovery. Further prospective studies are needed to confirm these findings and assess the long-term benefits of QLB. Keywords: erector spinae plane block, quadratus lumborum plane block, laparoscopic cholecystectomy, postoperative pain management, analgesia