Quadratus Lumborum Block Against Coupled Transversus Abdominis Block and Ilioinguinal/Iliohypogastric Nerve Blocks for Postoperative Analgesia After Total Abdominal Hysterectomy: A Randomized Controlled Trial

Abstract

Background: Nerve blocks have been one of the most common anesthetic methods for abdominal surgeries since the last four decades. Objectives: This study aimed to compare the postoperative analgesic efficacy of bilateral ultrasound-guided quadratus lumborum block (QLB) against bilateral ultrasound-guided transversus abdominis block (TAB) and Ilioinguinal/Iliohypogastric nerve blocks (IINB) in abdominal total hysterectomy. Methods: Sixty female patients scheduled for the surgery of total abdominal hysterectomy under spinal anesthesia participated in this randomized prospective trial. They were randomly assigned to two dual TAB / IINB (n = 30) and QLB (n = 30) groups. Moreover, the visual analog scores (VAS), the total amount of morphine consumed after surgery during the first 24 hours, the number of individuals requiring rescue analgesia, postoperative analgesia duration, and postoperative complications were recorded. Results: Morphine consumption was equal in both groups (P = 0.908). Furthermore, the analgesia duration in the two groups was statistically insignificant (P = 0.879), with mean values of 15.4 and 15.6 hours, respectively. During 24 hours, there was no statistically significant difference in terms of VAS between the two groups (P > 0.05). Conclusions: The QLB might be a viable replacement for TAB/IINB for postoperative analgesia after total abdominal hysterectomy.