Comparative Evaluation of Quadratus Lumborum Block and Transversus Abdominis Plane Block in Postoperative Pain Control Following Lower Abdominal Surgeries

Background: Efficient postoperative pain management is crucial for patient comfort, prompt mobilisation, and decreased hospital duration after lower abdominal procedures. Regional anaesthesia techniques have become increasingly favoured for their capacity to reduce opiate consumption and associated adverse effects. The Transversus Abdominis Plane (TAP) block and Quadratus Lumborum (QL) block are two frequently employed ultrasound-guided fascial plane blocks. Although both aim for abdominal wall analgesia, their anatomical distribution and duration of effect may vary considerably.

Aim: This study aims to compare the efficacy of QL block and TAP block in controlling postoperative pain following lower abdominal surgeries.

Materials and Method: A prospective study was conducted on 80 patients undergoing elective lower abdominal surgeries under general anaesthesia in a tertiary care centre. Participants were randomly assigned to receive either an ultrasound-guided QL block or TAP block postoperatively. Pain scores were assessed using the Numerical Pain Intensity Scale (NPIS) at rest and during movement at 2-, 6-, 12-, and 24-hour post-surgery. Secondary outcomes included total opioid consumption and time to first rescue analgesia.

Results:  Patients in the QL block group reported significantly lower NPIS scores at all observed time intervals compared to the TAP block group (p < 0.05). Additionally, opioid requirements were lower, and the time to first rescue analgesia was longer in the QL group, indicating prolonged analgesic duration and effectiveness. Hemodynamic parameters remained stable in both groups, with no significant adverse events, confirming the safety and superior analgesic efficacy of the QL block.

Conclusion: The QL block offers superior and longer-lasting postoperative pain relief compared to the TAP block in patients undergoing lower abdominal surgeries. Its use may contribute to enhanced recovery and reduced opioid consumption.