Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block in Post-Operative Pain Management after Open Appendectomy

Abstract

he goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using multimodal analgesic therapy, preference for regional techniques, avoidance of sedatives, non-invasive ventilation with supplemental oxygen and early mobilization. In the past few years, transversus abdominis plane (TAP) block has been increasingly used for postoperative pain relief after appendectomy. The main advantage of quadratus lumborum block (QLB) compared to TAP block is the extension of local anesthetic agent beyond the transversus abdominis plane to the thoracic paravertebral space. The wider spread of the local anesthetic agents may produce extensive analgesia and prolonged action of the injected local anesthetic solution. The aim of this study was to assess the analgesic efficacy of ultrasound-guided trans-muscular QLB compared with TAP block during appendectomy surgery and in the early postoperative period regarding pain relief, provision of comfort, and improved respiratory functions.