Ultrasound-guided posterior quadratus lumborum block for postoperative pain after laparoscopic cholecystectomy: A randomized controlled double blind study

Study objective: Laparoscopic techniques are commonly used in surgical operations of the gallbladder. There are very few regional anesthesia methods used to achieve this goal. We aimed to investigate the effect of ultrasound-guided posterior quadratus lumborum block (QLB), administered bilaterally on pain scores after laparoscopic cholecystectomy operations. Design: Prospective, double blind, randomized controlled clinical trial. Setting: Single-institution, tertiary hospital. Patients: 60 patients underwent laparoscopic cholecystectomy were included in the study. Interventions: Patients were randomized to either Group B (intravenous patient-controlled analgesia (IV PCA) + posterior QLB with 0.3 ml/kg 0.25% bupivacaine; n = 30) or Group S (IV PCA + posterior QLB with 0.3 ml/kg 0,9% saline; n = 30). Measurements: Postoperative pain (during rest) was evaluated at the 30th minute, 2nd, 6th, 12th, and 24th hours using the VAS scores. Postoperative activity pain was also evaluated with VAS at the 2nd, 6th, 12th, and 24th hours. Postoperative 6th, 12th, and 24th hour follow-up results were recorded to identify the quantity of tramadol use. Secondary outcomes included the Ramsey sedation scale (RSS), side effect profile, and additional analgesic use. Main results: The VAS scores between the two groups were found to be statistically significantly lower in Group B (p < 0.001). The mean values of the quantity of tramadol use at the 6th, 12th, and 24th hours were found to be statistically significantly lower in Group B (p < 0.001). There was no statistically significant difference in the rate of side effects (p = 0.309) and RSS (p = 0.505) outcomes between the groups. Conclusions: As a result of this study, we think that posterior QLB administered for pain palliation after laparoscopic cholecystectomy operation is an effective analgesia technique.