COMPARISON OF EFFICACY OF POST OPERATIVE ANALGESIA BY ULTRASOUND GUIDED ERECTOR SPINAE BLOCK AND QUADRATUS LUMBORUM BLOCK IN TOTAL ABDOMINAL HYSTERECTOMY

Abstract

ACKGROUND : Post-operative pain management can be a significant challenge for medical and nursing staff in everyday clinical practice. The erector spinae plane (ESP) block at the T5 thoracic level for the relief of neuropathic pain. This blocks both the posterior and anterior rami as well as the sympathetic ganglia in the thoracic paravertebral region. The quadratus lumborum block, also known as a "interfascial plane block," is a posterior abdominal wall block. There are very few comparative studies on efficacy of postoperative analgesia of ESB and QL block with many limitations. Hence, our study is meant to examine the efficacy of postoperative analgesic ultrasonography guided erector spinae block and quadratus lumborum block in lower abdominal procedures. METHODOLOGY: Present study is a randomised control trial where 66 patients with ASA grading I and II are included. Patients are divided into 2 groups. GROUP A – These patients will receive ultra sound guided erector spinae plane block at T 9 level bilaterally with 20 ml of 0.25% bupivacaine with 4mg of dexamethasone on each side. GROUP BThese patients will receive ultra sound guided posterior quadratus lumborum block bilaterally at T9 level with 20ml of 0.25% bupivacaine with 4 mg of dexamethasone on each side . Both the groups are checked for HR, MABP, duration of action of block , amount of rescue analgesia, no. of times rescue analgesia is given and total amount of drug administered, , VAS at rest at 2nd, 6th, 12th, 14th hrs and VAS at movement at 2nd, 6th, 12th, 14th and patient satisfaction score. RESULTS: There is no statistically significant difference in demographic and hemodynamic parameters between both groups. VAS scores of Group A ( ESPB group ) are lesser than xxi Group B (QLB group). indicates Group A ( ESPB group ) had higher duration of analgesia than Group B (QLB group). In group ESPB total amount of drug used is less than of group QLB.