Effectiveness of Anterior Quadratus Lumborum Block Versus Intravenous Paracetamol for Pain Management in Laparoscopic Cholecystectomy

Objective: Laparoscopic procedures are widely preferred in gallbladder surgery; however, effective postoperative analgesia remains an important clinical concern.This study was designed to evaluate whether bilateral ultrasound-guided anterior quadratus lumborum block (QLB) offers improved postoperative pain control compared with intravenous (IV) paracetamol in patients undergoing laparoscopic cholecystectomy.Method: Sixty adult patients scheduled for elective laparoscopic cholecystectomy and meeting the inclusion criteria were retrospectively analyzed.Patients were allocated into two groups: those receiving anterior QLB (n=29) and those treated with IV paracetamol alone (n=31).Postoperative outcomes assessed during the first 24 hours included visual analog scale (VAS) pain scores, total opioid consumption, Richmond Agitation-Sedation Scale (RASS) scores, and the incidence of nausea, vomiting, and shoulder pain.Results: Pain intensity and opioid requirements measured at 30 minutes, and at 2, 4, 12, and 24 hours after surgery were consistently lower in the QLB group than in the IV paracetamol group (p<0.001 at all evaluated time points).In addition, patients who received anterior QLB demonstrated a calmer and more stable emergence from anesthesia, as reflected by significantly lower RASS scores (p<0.001).The frequency of postoperative nausea, vomiting, and shoulder pain did not differ significantly between the groups.Conclusion: Bilateral anterior quadratus lumborum block provides more effective postoperative analgesia than intravenous paracetamol in laparoscopic cholecystectomy and is associated with a marked reduction in opioid consumption.These findings support the use of anterior QLB as a valuable component of multimodal analgesia strategies for this surgical population.