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Abstract
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Background and Aims This study aimed to compare the analgesic efficacy of two approaches to the Quadratus Lumborum Block (QL Block) i.e. QL-2 and QL-3 blocks in patients who underwent total laparoscopic hysterectomy (TLH).
Methods This randomized controlled trial was conducted on 60 patients who underwent TLH under general anesthesia and were randomized into the QL-2 and QL-3 groups. The total 24-hour postoperative fentanyl consumption, time to request for first rescue analgesic and the Numerical Rating Score (NRS) were noted in the postoperative period.
Results The mean total Fentanyl 24-hour consumption was not significantly different between the groups. In QL-2 it was 56.83 ± 10.94 mcg vs 53.00 ± 12.21 mcg in group QL-3 (p-value- 0.20). The mean time to first rescue analgesia however was more when QL2 block was given at 17.40 ± 2.72 hours vs 19.30 ± 2.27 hours in QL-3 (p-value 0.005). No statistically significant difference in pain was noted by the mean NRS at 1 hour, 6 hours and 24 hours. At 12 hours however, in group QL-2 the mean NRS was 3.27 ± 1.01 and in group QL-3 it was 2.70 ± 1.14 (p-value-0.04)
Conclusions Both QL-2 and QL-3 blocks appear equally effective for postoperative analgesia after TLH. A statistically significant difference in time to first rescue analgesia and better NRS at 12 hours has been noted in patients who received QL-3 block; however, it may not have much clinical significance.
Comparison of Total amount of Fentanyl used, Time for First resque analgesia and NRS score at various intervals across the groups