Comparison Of Recovery Quality Between Ultrasound-Guided Quadratus Lumborum Block And Transversus Abdominis Plane Block On Patients Undergoing Total Laparoscopic Hysterectomy

Objective:Aimed to compare the quality of recovery between bilateral ultrasound-guided quadratus lumborum block(QLB)and bilateral transverse abdominis plane(TAP)block on patients undergoing total laparoscopic hysterectomy.Methods:Seventy-two female patients scheduled for total laparoscopic hysterectomy were randomized into two equal groups(QLB group and TAP group).Each patient received bilateral TAP block or bilateral QLB before anesthesia induction.Patients in both groups received the same anesthesia induction and management.Following indexes were recorded:Quality of Recovery-15 Score(QoR-15)on 1 day before the operation and 24h,48h,3d after the operation;first time of getting out of bed;first exhaust time of anus;and number of patients needed rescue analgesia and any side effects;visual analogue scale(VAS)score and Bruggrmann comfort scale(BCS)score on preoperative 1 day and 2h,4h,8h,12h,24h,48h,3d after operative;intraoperative analgesic drug use;the patient's heart rate(HR)and blood pressure(BP)before anesthesia induction,before intubation,after successful intubation,at time of skin cutting and 1min after the establishment of pneumoperitoneum;and the time taken to complete ultrasound-guided nerve block.Results:Compared with the TAP group,patients in the QLB group had higher QOR-15 scores at 24h and 48h after surgery,shorter the first out-of-bed activity time and the first transanal exhaust time,the incidence of postoperative remedial analgesia and adverse reactions was lower(P<0.05).In contrast with the TAP group,patients had lower VAS scores at 2h,4h,12h,24h,48h after the operation and higher BCS scores at 3d after the operation and the time taken to complete ultrasound-guided nerve block is longer(P<0.05).There was no statistical difference in other indexes.Conclusion:Quadratus lumborum block is more beneficial to the early recovery of patients with laparoscopic hysterectomy than transversus abdominis plane block.