Analgesic Effects of Ultrasound-Guided Transmuscular Quadratus Lumborum Block (QLBTM) Using Different Volumes and Concen- trations of Local Analgesics after Unilateral Inguinal Hernia Repair

Document Type : Original Article


The Department of Anesthesia, Surgical Intensive Care and Pain, Faculty of Medicine, Cairo University


Abstract Background: After abdominal surgery, the low thoracic epidural continues to be the "gold standard" for postoperative analgesia. Unfortunately, not all patient populations can or should receive analgesia based on an epidural. Patients who cannot get a central neuro-axial method of analgesia are a result of the trend toward short-stay surgery, the adoption of fast track surgical procedures, the general lack of monitored beds, the occurrence of infection or a bleeding tendency, and other factors. Thus, effective substitutes for intrathecal and epidural-based analgesia during abdominal surgery are required. Aim of Study: To determine if the USG-QLBTM, an ultrasound-guided transmuscular quadratus lumborum block, reduces postoperative discomfort in patients who have had unilateral inguinal hernia surgery, two different concentra-tions/volumes of local bupivacaine as an anaesthetic were compared. Patients and Methods: Patients who have had unilateral inguinal hernia repair were recruited in this randomised research. Two groups of patients were assigned at random and given different doses of anaesthesia: Group A got 30 ml LA (75mg of bupivacaine plus 15ml of saline), whereas Group B were given 40ml LA (50mg of bupivacaine plus 30ml of saline). A visual analogue score was used to quantify postop-erative pain at intervals of 10 minutes, as well as 30 minutes, also 60 minutes, further 12 hours, 24 hours, and 48 hours. Surgical complications were also recorded. Results: 32 people in total participated in the study. There were no statistically significant differences in hemodynamic parameters, postoperative opioid use, or demographic infor-mation between the two groups. Patients in group B, who received bigger volume but lower concentration of local anaesthetic solution compared to group A, reported higher patient satisfaction scores and postoperative analgesia durations. Conclusion: Following unilateral inguinal hernia surgery, ultrasound-guided QLBTM can be a component of a well-balanced postoperative analgesia. Using high volume and low concentration of local anesthetic (bupivacaine) can prolong postoperative analgesia duration. To sustain postoperative pain reduction, the ideal local anaesthetic concentration and volume must be determined through more study.