Effect of Ultrasound Guided Quadratus Lumborum Block as Post-Operative Analgesia after Laparoscopic Cholecystectomy

Abstract

oorly controlled acute pain after abdominal surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay and an increased likelihood of chronic pain. The analgesic regimen used for postoperative pain control needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient, together with inhibition of trauma –induced nociceptive impulses. Many studies have been carried out trying to find a solution for this dilemma thus different pain modalities as local infiltration of the surgical field, systemic analgesia (narcotics and non-narcotics), neuro-axial blocks, and nerve blocks shined out, however each has shown its side effect which limits its use to specific cases. Abdominal field blocks have been extensively used for a variety of surgical procedures for many years. They are simple to perform and have a good safety profile. The aim of this study was to assess the postoperative analgesic efficacy of quadratus lumborum block (QLB) compared to general anesthesia with multimodal routes of analgesia as paracetamol, ketorolac and morphine after laparoscopic cholecystectomy regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received.