Ultrasound-guided Quadratus Lumborum block versus erector spinae block for postoperative analgesia in hepatic surgery patients: Randomized controlled clinical study.

Background: facial plane blocks become a popular analgesic technique for thoracic and abdominal procedures. Objective: this study aimed to compare the effect of bilateral erector spinae plane block (ESPB) with bilateral quadratus lumborum block (QLB) in decreasing analgesic consumption in patients scheduled for common bile duct exploration (CBD).Methods: This prospective randomized single-blind controlled trail included 90 patients with ASA I-II who were scheduled for CBD exploration under general anesthesia in Minia university hospital. Patients ranged in age from 18 to 60. Three parallel, equal groups of patients were assigned: The (ESB) group had bilateral, ultrasound-guided ESP blocks at T7 with 20ml of 0.25 percent bupivacaine injected into each side. (QL) group got the same dosage of an ultrasound guided bilateral QL block. The (C) group did not get any blocks. The computation of total opioid intake was the primary goal, while the timing of the initial analgesic need and the visual analogue pain score (VAS) on the first postoperative day were the secondary outcomes.Results: We reported less fentanyl consumption in ESB group 80 (37.5-100) μg than QLB group 150 (120-152.5) μg and both showed lower consumption than c group 250 (200-272.5) mcg. In respect to VAS at rest/dynamic ESB group showed lowest score in the first 8hrs postoperative with longest duration of analgesia.Conclusion: Bilateral ultrasound guided erector spinae plane block decreases resting and dynamic pain score, fentanyl consumption and increases postoperative analgesic duration than quadratus lumborum block for patients undergoing CBD exploration.