Postoperative Narcotic Sparing Effect of Ultrasound Guided Quadratus Lumborum Block in Patients Undergoing Percutaneous Nephrolithotomy

Background:. Quadratus lumborum block (QLB) technique is strongly recommended as an appropriate adjunctive to systemic intravenous analgesia for pain control. Some modifications of this technique were subsequently introduced. Aim of the Work: The purpose of this study is to assess the effectiveness of quadrates lumborum plane block as a post-operative analgesic with Percutaneous Nephrolithotomy. Patients and Methods: A prospective randomized controlled single-blinded clinical research study on 98 patients was conducted at Al-Azhar University hospitals in Cairo. After receiving institutional ethics committee approval, patients were scheduled for Percutaneous Nephrolithotomy. 98 patients were randomly divided into two equal groups: 49 patients given GA (General Anesthesia) & postoperative analgesia in the form of paracetamol 1gm/ 8hrs & Morphine as required, 49 patients, in addition to GA, the patient received preoperative ultrasound guided quadratus lumborum block. Results: the results of this study showed that QLB showed significant difference than control group in hemodynamics. In terms of duration of analgesia and total analgesic consumption, QLB is better than control group with P < 0.001, P < 0.001, respectively. Conclusion: US-guided QLB provided satisfactory analgesia in patients undergoing PCNL. It lengthened the analgesia's duration and reduced opioid consumption and postoperative pain scores. Patients in the QLB group significantly showed more hemodynamic stability and less variations from baseline. No serious complications were reported related to the technique. Accordingly, US-guided QLB is strongly recommended for postoperative pain management in patients undergoing PCNL.