الفهرس 
Anatomy of the Abdominal WallOnly 14 pages are availabe for public view
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Abstract
Background: Perioperative pain management using truncal nerve blocks became a part of anesthetic management for abdominal surgeries 40 years ago. Since then, newer techniques for truncal blocks are being introduced, such as the ilioinguinal-iliohypogastric block, rectus sheath block, TAP and QL blocks in the abdomen.
Aims: To compare between the analgesic effect of ultrasound guided quadratus lumborum block versus transversus abdominis plane block in patients undergoing para umbilical hernia repair as regard pain control by measuring VAS score as a primary outcome, and measuring vital data (SBP, DBP, MABP and HR) from PACU till 24hrs post operative PACU (30 mins in PACU and then 2hrs, 4hrs, 8hrs, 12hrs, 24hrs post operative), the total amount of rescue analgesia and the first time to request it in the 24hrs post operative as a secondary outcomes.
Patients and Methods: After approval of the anesthesiology department and scientific and ethical committees, this prospective randomized clinical trial study was conducted in Ain Shams University Hospitals. 46 patients were included in the study and divided randomly and equally into two groups. group QLB (n=23) and group TAP block (n=23). group QLB: ultrasound guided QL block performed with bilateral injection of 0.2 ml/kg bupivacaine 0.25% at the posterior border of the quadratus lumborum muscle. group TAP: ultrasound guided TAP block with bilateral injection of 0.2 ml/kg bupivacaine 0.25% between the internal oblique and transversus abdominis muscles.
Results: The result of the study revealed that the quadratus lumborum block is more effective in pain control than transversus abdominis plane block following paraumbilical hernia repair, the results as regard VAS score and postoperative vital data (SPB, DBP, MABP, HR) from PACU till 24hrs postoperative was lower in QL group than TAP group, the total amount of pethidine was lower in QL group and the first time to request rescue analgesia was longer in QL group.
Conclusions: The study concluded that quadratus lumborum block is more effective for pain control following paraumbilical hernia repair than transversus abdominis plane block and less need for opioid postoperative as a rescue analgesia