Quadratus Lumborum Block vs Erector Spinae Plane Block in Abdominal Hysterectomy

Postoperative pain following abdominal hysterectomy is a challenging concern as some patients suffer acute pain that could let to chronic pain over time following the surgery. Epidural analgesia which is the gold standard for postoperative pain management in abdominal surgeries including abdominal hysterectomy has side effects such as hypotension, hematoma, motor weakness of lower limbs, paresthesia, intrathecal placement of the epidural catheter and urinary retention that could prolong hospital stay. Since high frequency ultrasound machines' usage has increased in postoperative analgesia management, ultrasound guided fascial plane blocks has been performed by clinicians with high success rate. To avoid possible complications of epidural catheter placement and epidural analgesia, various techniques has been applying for an analgesic effect close to the effectiveness of epidural analgesia. These techniques include transversus abdominis plane block, rectus sheath block, wound infiltration of local anesthetics, erector spinae plane block and quadratus lumborum plane block. However, each of the plane blocks has limitations individually which prevent them to be the unique analgesic technique for postoperative analgesia following abdominal surgery. As far as the authors knowledge, there's no reported study which compares ultrasound guided erector spinae plane block versus ultrasound guided quadratus lumborum type III block (anterior quadratus lumborum block) as a preemptive analgesia technique in patients undergoing abdominal hysterectomy.

Inclusion Criteria:Patients who accepted to participate and signed written consentAged between 18 and 75American Society of Anesthesiologists (ASA) physical score I or IIElective abdominal hysterectomy operationExclusion Criteria:Patients who declined to participateBMI > 35 kg/m2Uncontrolled systemic disease<18 age and >75 ageUnable to cooperate (mental retardation)Low cardiac capacityHypersensitivity history to the agents to be usedCoagulopathyLocal infectionsOpioid addiction history