Effects of erector spinae plane block and transmuscular quadratus lumborum block on postoperative opioid consumption in total laparoscopic hysterectomy: a randomized controlled clinical trial
Total laparoscopic hysterectomy (TLH) is a preferred alternative to open abdominal hysterectomy because of its minimal invasiveness, fewer complications and faster recovery. However, THL is frequently associated with substantial postoperative pain. As part of multimodal analgesia, the techniques of interfascial plane block have been demonstrated to be effective with technical safety and simplicity. In this randomized clinical trial, we compared the analgesic efficacy of two novel interfascial plane blocks, erector spinae plane block (ESPB) and transmuscular quadratus lumborum block (TQLB) with total intravenous anesthesia (CON) in patients undergoing TLH. We found that The cumulative sufentanil consumption at 12 h postoperatively was significantly lower in Group ESPB than in Group CON (median [interquartile range], 0 [0, 4] μg vs. 6 [0, 10] μg; median difference = -3; 95% confidence interval, -6 – 0; P = .010). There were no significant differences between Group TQLB and CON (0 [0, 4] μg vs. 6 [0, 10] μg; P = .098) or between Group ESPB and TQLB (P = 1.000). When compared with Group CON, ESPB and TQLB persistently reduced pain scores until 6 h and 4 h after surgery, respectively (P < .05). However, no significant differences were found in pain scores between the two block groups. Thus, we concluded that ESPB and TQLB improved the quality of multimodal analgesia for TLH. ESPB may be more favourable due to the prolonged period of analgesia and decreased opioid consumption after TLH.