Combined Intra-peritoneal and Incisional Infiltration versus Bilateral Ultrasound Guided Quadratus lumborum Block using Bupivacaine Plus Magnesium Sulphate in Abdominal Hysterectomy

Alansary, Maged Mohamed Shawky; Sedek, Abd Elmonsef Abd Elhamid Moustafa; El Garhy, Ahmed Mahmoud Mohammed; Al Wakel, Ahmed Mohamed Mahmoud

doi:https://doi.org/10.21608/aimj.2025.446658

Combined Intra-peritoneal and Incisional Infiltration versus Bilateral Ultrasound Guided Quadratus lumborum Block using Bupivacaine Plus Magnesium Sulphate in Abdominal Hysterectomy

Document Type : Original Article

Authors

¹ Professor of Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine for boys, Al-Azhar University, Cairo, Egypt

² Professor of Obstetrics and Gynecology Department, Faculty of Medicine for boys

³ Assistant professor of Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine for boys, Al-Azhar University, Cairo, Egypt

⁴ MSc, Anesthesia, Intensive Care, and Pain Management Department, Faculty of Medicine for boys, Al-Azhar University, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446658

Abstract

Background: Frequent gynecological surgery is a hysterectomy, which often causes agonizing, chronic discomfort.
Aim of the Work: Compare the combined intraperitoneal instillation and incisional infiltration with the bilateral ultrasound-guided QL2 block following abdominal hysterectomy.
Patients and Methods: This planned, double-blind, randomized experiment was a survey that took place in Al-Azhar University Hospitals, Obstetrics and Gynecology Department, on 70 females undergoing abdominal hysterectomy, divided into two equal groups. Group (IP): A volume of 30 mL solution consisting of 50 mg of bupivacaine 0.25% (20 mL) plus 1 g of magnesium sulfate (10 mL) was instilled intraperitoneally, then the same doses and volume were infiltrated into the abdominal wall after closure of the abdominal incision. Group (QLB): Bilateral QL2 block with a volume of a 30 mL solution consisting of 50 mg of bupivacaine 0.25% (20 mL) plus 1 g of magnesium sulfate (10 mL) in each muscle.
Results: Group QL noticed a lot more time to begin seeking analgesia than group IP (P <0.05). At baseline, PACU, 12 hours, and 24 hours, there were no significant variations in the concentrations of cortisol and glucose between the two groups (P>0.05). Group QL reported a significantly lower hospital stay than group IP (P <0.05).
Conclusion: The ultrasound-guided QL block decreased lengths of hospital stay and give better postoperative pain control compared to IP group with a delay in request analgesia for the initial time.

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