2023, Vol. 6, Issue 4, Part A

Background: Our hypothesis posited that the quadratus lumborum block (QLB) is superior to both local wound infiltration (LWI) and the transversus abdominis plane (TAP) block in reducing visual analogue scale (VAS) and overall morphine use. The aim of this study was to assess and contrast the pain-relieving effectiveness of ultrasound guided QLB, ultrasound guided TAP block, and LWI in female patients undergoing abdominal hysterectomy.

Methods: The study was carried out on a sample of 105 female patients, ranging in age from 40 to 65 years, who had an ASA physical status of I or II. The participants were scheduled to have elective abdominal hysterectomy, and the trial was conducted using a prospective randomized, double-blinded design. The participants were allocated into 3 equal groups by a random process, with each group including 35 individuals. Group I: Ultrasound-guided QLB group. Group II: Ultrasound-guided TAP group. Group III: LWI group.

Results: VAS showed a statistically significant difference among the 3 groups at 6, 12, and 24 hours (P value <0.001), while no significant difference occurred at 1, 2, and 4 hours among 3 groups. After 6 hours, the VAS scores were similar in group I and group II, but considerably lower in both groups compared to group III (p<0.001). After 12 hours, the VAS score was considerably lower in group I compared to group II and group III. Additionally, there was an increase in VAS score in group III when compared to group II (p<0.05). After 24 hours, a comparison among 3 groups revealed a drop in VAS in group I compared to the other two groups (p<0.05), although there was no significant difference between group II and group III.

Conclusions: Ultrasound-guided QLB outperformed Ultrasound-guided TAP block and LWI in managing postoperative pain after abdominal hysterectomy. This superiority was shown in terms of pain score, total morphine use, duration of pain relief and time of first request for pain relief.