A prospective randomised double blinded study-to evaluate the analgesic efficacy of transmuscular quadratus lumborum block in percutaneous Nephrolithotomy via VAS score

Abstract

Introduction: Before the advent of ultrasound guided regional anaesthesia, post-operative pain in percutaneous nephrolithotomy was mainly confined to opioid consumption and other analgesics. The use of Ultrasound in regional anaesthesia has facilitated the visualization of anatomical structures, needle advancement and the spread of local anaesthetic. This has led to the development and refinement of fascial plane blocks. Quadratus Lumborum block (QLB) facilitates early postoperative ambulation and reduction in length of hospital stay by effective postoperative analgesia. Methods: In this prospective, randomised, double blinded study, 66 patients scheduled for elective percutaneous nephrolithotomy (PCNL) between 2021 and 2022 were randomised, 33 patients to receive ultrasound guided QLB with 20 ml of 0.25% bupivacaine and 33 patients receive 20 ml of normal saline post intubation. During the postoperative period, each patient’s pain level was assessed by the Visual analog scale(VAS) score for pain: range 0-10 (0=no pain,10=worst pain ever).The VAS score at 15 mins,1hr, 2hr, 6hr,12hr, 24hr intervals, should be monitored. Results: VAS Score in Group A was less as compared to Group B. The difference was statistically significant at 15 min, 1h, 2h, 4h, 6h, 8h, 14h. Conclusion: Hence, ultrasound guided Transmuscular QLB had better analgesic efficacy in post PCNL surgery.