Comparison of Anterior Quadratus Lumborum Block Versus Lumbar Erector Spinae Plane Block for Postoperative Analgesia in Total Abdominal Hysterectomy: A Randomized Controlled Study
A Prospective Randomized Clinical Study
DOI:
https://doi.org/10.31636/pmjua.v10i3-4.4Keywords:
Anterior Quadratus Lumborum Block, postoperative analgesiaAbstract
Background: Total abdominal hysterectomy (TAH) is commonly associated with significant postoperative pain. Multimodal analgesia incorporating regional blocks is now the standard of care. Among these, the lumbar erector spinae plane (ESP) block and anterior quadratus lumborum (AQL) block are frequently used.
Objectives: To compare the efficacy of anterior quadratus lumborum (AQL) block and lumbar erector spinae plane (ESP) block in providing postoperative analgesia for patients undergoing TAH.
Methods: This prospective, randomized, double-blind interventional study included 44 patients undergoing TAH. Participants were randomly assigned to receive either a bilateral AQL block (Group A) or a bilateral lumbar ESP block (Group B) before surgery, under ultrasound guidance. All patients underwent general anesthesia. Pain was assessed postoperatively at regular intervals over 24 hours using the Visual Analogue Scale (VAS). Additional analgesic requirements and any complications were documented.
Results: Group A (AQL block) had a significantly longer mean duration of analgesia (8.5 ± 0.96 hours) compared to Group B (ESP block, 7.5 ± 1.09 hours; p = 0.00411). Total analgesic consumption in the first 24 hours was also lower in Group A (mean 2.36 ± 0.49) versus Group B (3.23 ± 0.68; p < 0.00001). No block-related complications were noted.
Conclusion: The AQL block provided statistically superior postoperative analgesia compared to the lumbar ESP block in patients undergoing TAH. However, the clinical difference in analgesic duration was marginal. Either block may be employed based on clinician expertise and institutional protocol.
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Copyright (c) 2025 Rashmee Chavan, Akshat Goklani, Gaurav Chavan, Vinayak Mali
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License
