Ultrasound Guided Transversus Abdominis Plane Block versus Quadratus Lumborum Block for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy

Abstract

Background: A multimodal pain management regimen is necessary to regulate intense pain following abdominal hysterectomy, which is regarded as a significant abdominal surgery. This study aimed to improve pain quality using ultrasound guided transversus abdominis plane block versus quadratus lumborum block in elective total abdominal hysterectomy under general anesthesia. Methods: This study included 63 patients were randomly allocated into three equal groups, each group consist of 21 patients. Group C served as control group, where each patient received only general anesthesia. Group Transversus abdominis plane (TAP), each patient was administered general anesthesia plus bilateral TAP block. Group Quadratus lumborum (QL) involved patients receiving general anesthesia with bilateral QL block. Results: The duration of the block's performance was shorter in the TAP group compared to the QL group. The visual analogue scale score at 30 minutes, 2, 4, and 8 hours after the operation was considerably lower in the (TAP&QL) groups compared to group C. The timing of the initial administration of pain relief medication (nalbuphine) was considerably earlier in the TAP group compared to the QL group. The number of patients requiring further pain relief and the total amount of nalbuphine administered within 24 hours after surgery were significantly lower in the QL group compared to both the C group and the TAP group. Conclusion: transversus abdominis plane block and quadratus lumborum block are effective and safe for improving postoperative pain relief in patients having elective total abdominal hysterectomy, with quadratus lumborum block being more effective in managing pain.