Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy- A RCTCorrespondence Address :
Junior Resident, Department of Anaesthesiology and Critical Care, Uttar Pradesh University of Medical Sciences, Saifai, Uttar Pradesh, India.
Introduction: Abdominal Hysterectomy (AH) is one of the most common surgeries performed in gynaecology and is associated with a medium to high pain level. Newly discovered peripheral blocks such as Transversus Abdominis Plane (TAP) block and Quadratus Lumborum (QL) block have gained immense popularity as an adjunct to regional and general anaesthesia for postoperative pain management and reducing analgesic requirements.
Aim: To compare the analgesic efficacy of QL block with TAP block in patients undergoing total AH.
Materials and Methods: This was a double-blinded Randomised Clinical Trial (RCT). The study population comprised of 105 patients posted for elective total AH under spinal anaesthesia. They were randomly allocated into three groups of 35 patients each. Group Q received bilateral QL block with 40 mL of 0.25% bupivacaine divided on either side, Group T received bilateral TAP block with 40 mL of 0.25% bupivacaine divided on either side and in Group C no block was given. Patients were monitored for Visual Analogue Scale (VAS) scores at 0, 15 minutes, 30 minutes, 1st, 2nd, 6th, 12th and 24th hour postoperatively, time for first analgesic requirement, total analgesic requirement in 24 hours and patient satisfaction score after 24 hours and also adverse effects, if any. Data were analysed using Statistical Package For The Social Sciences (SPSS) version 16 (Chicago, IL, USA) with independent t-test and Chi-square test as appropriate. The p<0.05 was considered statistically significant.
Results: There were significantly lower VAS scores in group Q than group T at 2nd and 6th hour with p-value of 0.003 and 0.001, respectively. The time for first analgesic was early in group C with mean value of 1.37±0.74 hours and it was 4.63±0.97 hours in group T and 7.77±1.51 hours in group Q. The total analgesic requirement was lesser in group Q when compared to group C and T. Patient satisfaction score was comparable between group Q and T (p=0.97). No significant difference in complications among the three groups was observed (p=0.51).
Conclusion: QL block is a better postoperative analgesic technique than TAP block for postoperative analgesia in hysterectomy patients.
Bupivacaine, Pain management, Randomised clinical trial, Visual analogue scale
Date of Submission: Jul 23, 2020
Date of Peer Review: Sep 08, 2020
Date of Acceptance: Nov 24, 2020
Date of Publishing: Feb 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jul 26, 2020
• Manual Googling: Nov 05, 2020
• iThenticate Software: Dec 28, 2020 (19%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)