Comparison between ultrasound-guided transversus abdominis plane block and quadratus lumborum block for open nephrectomy surgeries

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Abstract

Background
This prospective randomized study was performed on 80 patients, 21–60 years old, scheduled for open nephrectomy surgery. Patients were equally allocated to two groups: the transversus abdominis plane block (TAPB) group and the quadratus lumborum block (QLB) group. Both groups received 0.3 ml/kg of bupivacaine 0.25% on the side of the operation. Total postoperative pethidine consumption, time to rescue analgesia, postoperative visual analogue scale (VAS), and pethidine-related postoperative nausea and vomiting (PONV) were recorded.
Results
Total postoperative pethidine consumption was significantly lower in the QLB group: 73.75 ± 23.99 mg versus 115.63 ± 31.87 mg in the TAPB group. Time to 1st rescue analgesia was significantly prolonged in the QLB group: 477.075 ± 49.2 min versus 430.825 ± 48 min in the TAPB group. The VAS was significantly lower in the QLB group, on arrival to the Post-Anesthesia Care Unit (PACU), and at 1, 4, 8, and 12 postoperative hours. At 16 and 24 postoperative hours, both groups showed nonsignificant differences in the VAS scores. In the QLB group, 20% of patients had PONV versus 35% of patients in the TAPB group with no significant difference.
Conclusions
QLB efficiently reduced pain after open nephrectomy surgeries, in terms of quality and duration of pain control compared to TAPB.
Trial registration
FMASU MD 90a/2021/2022. The trial was registered on the 23rd of May 2021, with Pan Africa Clinical Trials Registry (PACTR202110858627849) on 27 October 2021

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