TITLE:
Effect of Bilateral Ultrasound-Guided Quadratus Lumborum Block versus Lumbar Epidural Block on Postoperative Analgesia following Major Lower Abdominal Cancer Surgery
AUTHORS:
Moaaz Mohamed Tohamy, Samy Abdelrahman Amr, Ashraf Amin Mohammed, Ahmad Mohamad Abd El-Rahman, Basma Rezk Farouk, Mohamed Galal Mostafa El-Naggar, Mahmoud Mostafa Mohammed, Montaser A. Mohamed
KEYWORDS:
Quadratus Lumborum Block, Lumbar Epidural Block, Postoperative Pain, Abdominal Cancer Surgery
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.11 No.12,
December
14,
2021
ABSTRACT: Background: Poor postoperative pain control leads to longer postoperative care, longer hospital stay and decreased patient overall satisfaction. Aim: To compare the efficacy and safety of bilateral ultrasound-guided quadratus lumborum block versus lumbar epidural block on the management of postoperative pain following major lower abdominal cancer surgery. Methods: The study was a double-blinded, and randomized study, conducted in South Egypt Cancer Institute, Assiut University, Egypt. It included cancer patients scheduled for major lower abdominal cancer surgery in the period from 2019 to 2020. They were divided into two groups: Group Ι received pre-emptive ultrasound-guided Quadratus Lumborum Block (QLB) with 25 mL of 0.25% bupivacaine on each side of the abdominal wall before induction of General Anesthesia (GA), and Group II received pre-emptive lumbar epidural block with 15 mL of 0.25% bupivacaine before induction of GA. VAS score, and time of the first analgesic request and postoperative total analgesic consumption were evaluated. Results: Sixty patients were included in our study. VAS score at rest was comparable between both studied groups in the first 6 h. At 8 and 10 h, Group II had a significantly higher VAS score at rest (P Limitation: Small sample size and shorter period for postoperative follow-up. Conclusions: Management of postoperative pain following major lower abdominal cancer surgery with US-guided QLB was associated with the reduction in the total analgesic consumption and delayed the first request of analgesia as compared to lumbar epidural block technique.