Comparative analgesic outcomes of anterior quadratus lumborum block and transversus abdominis plane block in patients undergoing laparoscopic cholecystectomy: A prospective observational study

Pain following laparoscopic cholecystectomy often necessitates substantial opioid use. This study aimed to compare postoperative analgesic outcomes among anterior quadratus lumborum block (QLB), transversus abdominis plane block (TAPB), and intravenous paracetamol within routine perioperative management of laparoscopic cholecystectomy. A total of 126 patients (42 per group: QLB, TAPB, IVA) undergoing elective laparoscopic cholecystectomy were evaluated. Postoperative outcomes recorded during the first 24 hours included Visual Analogue Scale (VAS) scores, rescue opioid consumption, Richmond Agitation-Sedation Scale scores, incidence of nausea and vomiting, and shoulder pain. VAS scores and opioid consumption at 30 minutes, 2, 4, 12, and 24 hours postoperatively were significantly lower in the QLB and TAPB groups compared with the IVA group (P < .001). Although 30-minute postoperative VAS scores were significantly lower in the QLB group compared with the TAPB group (P = .019), no clinically meaningful differences were observed between the 2 block techniques overall. Postoperative Richmond Agitation-Sedation Scale scores differed among groups, with the IVA group exhibiting greater variability in agitation-sedation profiles. No differences were found between groups in terms of postoperative complications. Both QLB and TAPB were associated with lower postoperative pain scores and reduced rescue opioid requirements compared with intravenous paracetamol in patients undergoing laparoscopic cholecystectomy. No clear clinically meaningful superiority was observed between the 2 block techniques. These findings should be interpreted in light of the prospective observational design and institutional analgesic protocol.