Comparison of ultrasonography guided quadratus lumborum block and transversus abdominis plane block for postoperative pain and analgesic consumption in total abdominal hysterectomy

Introduction and Aim: Poor pain control after hysterectomy is associated with prolonged hospital stay and recovery time, and also psychological changes, it also has an effect on quality of life and patient satisfaction. There fore, multimodal analgesia management is needed to control severe pain. With the introduction of ultrasound into the practice of anesthesia, progress has been made in regional nerve block applications. In our study, we aimed to compare the effect of quadratus lumborum block (QLB) and transversus abdominis plan block (TAP) on postoperative pain and analgesic consumption in patients undergoing total abdominal hysterectomy. Materials and Methods: Our study was performed on 60 patients with ASA risk classification I, II, and 45 to 60 years of age who will undergo hysterectomy, after local ethics committee approval. Following general anesthesia, QLB or TAP block was administered with USG before incision. Both blocks were administered 0.25% of bupivacaine 0.5 ml/kg. Perioperative hemodynamic parameters, VAS score was recorded at 30 min 2,4,8, 12, and 24 postoperative hours. If the VAS score is ≥ 4, 1 mg/kg of tramadol as an additional analgesic was administered intravenously. In addition, time of the first analgesic requirement, total number of patients in need of analgesics, side effects, complications were recorded. Results: The study was completed with 60 patients. VAS scores were statistically significantly lower in the QLB group than TAP block (p<0,05). The total amount of contramal used was statistically significantly lower in the QLB group than TAP block (p<0,05). Conclusion: In our study, it was observed that preoperatively applied QLB was superior to TAP block in terms of postoperative pain scores, total amount of contramal used in patients undergoing total abdominal hysterectomy. Key Words: Quadratus Lumborum Block, Transversus Abdominis Plan Block, Postoperative Pain