Abstract

BACKGROUND: In percutaneous nephrolithotomy surgeries post operative pain due to dilatation of the renal capsule, the parenchymal tract and placement of the nephrostomy tube is distressing to the patient. Quadratus lumborum (QL) block and Erector spinae (ESP) block are two emerging myofascial plane blocks that leverage multimodal analgesia to improve postoperative pain control. AIM:To compare the efficacy of ultrasound guided Quadratus lumborum block with 20 ml of 0.25% Bupivacaine and 8 mg Dexamethasone vs Erector Spinae block with 20 ml of 0.25% Bupivacaine and 8 mg Dexamethasone for post operative analgesia in patients undergoing PCNL surgeries under general anaesthesia. METHODS AND MATERIALS: Sixty patients scheduled for percutaneous nephrolithotomy were randomly allocated into two groups QLB and ESPB groups, patients received unilateral (QLBIII or ESPB) respectively, with 0.3–0.4 ml/kg of bupivacaine 0.25%. The primary outcome was the Pain relief by using Visual Analogue Score (VAS), time for the first rescue analgesic (inj. tramadol 2mg/kg I.V), number of rescue analgesics in first 24 hours post operatively, total dose of opioid in 24hrs of post op period. The secondary outcomes were the Hemodynamic parameters, any adverse events in the post operative period.
RESULTS: Demographic parameters i.e., age and sex (only male patients were included) showed no significant differences in the two groups. The Mean time of first rescue analgesia
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 10, Issue 05, 2023
239
in group Q and group E was 486±75 and 352±67 mins. and p value of 0.02 was statistically significant. Number of patients required analgesia in 24 hrs of post op in group Q and Group E was 10 and 19, and p value of 0.001 was statistically significant. Total dose of opioid consumption (mg) 33.33±40.46 and 96.44±94.4 in group Q and Group E. CONCLUSION: Ultrasound guided quadratus lumborum block provides better post operative analgesia than ultrasound guided erector spinae block in percutaneous nephrolithotomy.