Background: Erector spinae plane block (ESPB) and quadratus lumborum block (QLB) have demonstrated efficacy in providing postoperative analgesia following abdominal surgeries. However, evidence regarding their effectiveness in pediatric renal surgeries remain limited. The present study aimed to compare the duration of postoperative analgesia between ultrasound-guided quadratus lumborum and erector spinae plane blocks in children undergoing open pyeloplasty. Methods: Sixty children undergoing pyeloplasty, aged between 6 months and 7 years were randomized to receive ultrasound guided ESPB or QLB after induction of general anesthesia. Time to first rescue analgesia, total analgesic requirement, and time to perform the block were observed. Results: The time to first rescue analgesia was 1040 ± 99 min in QLB group as compared to 889 ± 67 min in ESPB group ( P < 0.001). Mean total analgesic requirement (fentanyl) in 24 hours was lower in QLB group as compared to ESPB group (1.77 ± 1.36 μg/kg and 3.9 ± 0.80 μg/kg, respectively) ( P < 0.001). The mean total time to perform block was 246 ± 107 sec in QLB group and 140 ± 80 sec in ESPB group ( P < 0.001). Conclusion: Ultrasound guided quadratus lumborum block provides longer duration of postoperative analgesia with lesser total analgesic requirement as compared to erector spinae plane block in children undergoing pyeloplasty, with marginally longer time to administer quadratus lumborum block.
Kaur et al. (2026) studied this question.