Erector Spinae Plane Versus Quadratus Lumborum Blocks for Pain Management After Total Abdominal Hysterectomy
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Erector Spinae Plane Block, Quadratus Lumborum Block (QLB).
- Who it may be relevant to
- Registry conditions: Post Operative Analgesia. Basic parameters: 35 years — 65 years · Female.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Pakistan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Comparative Efficacy of Erector Spinae Plane and Quadratus Lumborum Blocks in Managing Postoperative Pain for Total Abdominal Hysterectomy: A Randomized Controlled Trial
Overview
TAH, being a large scale gynaecological operation, is a construction bound to cause serious postoperative pain to the patient in that the procedure will inevitably entail massive tissue dissection. Management of this postoperative pain is of utmost significance because poor analgesia may lead to delayed mobilization of the patient, long duration of hospitalization and also general increase in the morbidity of postoperative period. Traditionally, in these facilities, opioid analgesics are the most common and the most popular means of controlling postoperative pain. Nevertheless, the varied and pervasive use of opioids is largely constrained by its well-reported, dose-dependent systemic adverse effects. Nausea, vomiting, sedation, and respiratory depression are complications that severely degrade the recovery process of the patient and reduce his or her satisfaction.
Detailed description
Patients who met the inclusion criteria were recruited in the trial after getting approval from the Hospital Ethical Review Committee and REU CPSP. Demographic information such as age, height, weight, body mass index as well as the functional classification (ASA) was documented on a pre-made proforma. Patients were randomized into two groups using a computer-generated randomisation process.
Group A: Received an ultrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine.
Group B: Received an ultrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine.
A qualified anaesthesiologist performed each block in aseptic settings prior to surgery. Standardised general anaesthesia was administered to each patient. The Visual Analogue Scale (VAS) was used to quantify pain at rest and on coughing at 2, 6, 12, 18, and 24 hours. Patents with VAS score more than 4, were given rescue analgesia and the cumulative amount of analgesics used in the first 24 hours as well as the time of the first rescue analgesia were recorded. Patient satisfaction with pain treatment as well as adverse effects such nausea, vomiting, and hypotension were tracked for a duration of 24 hours after the surgery
Interventions
- Procedure Erector Spinae Plane Block
Ultrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine. - Procedure Quadratus Lumborum Block (QLB)
Ultrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine.
Primary outcome measures
- Post Operative Pain [Time frame: 24 Hours]
Secondary outcome measures (4)
- Time to first Rescue Analgesia [Time frame: 24 Hourse]
- Cumulative Opioid consumption [Time frame: 24 Hours]
- Adverse effects [Time frame: 24 Hours]
- Patient Satisfaction [Time frame: 24 Hours]
Eligibility criteria
Inclusion criteria
Patients aged 35-60 years. ASA physical status I or II. Elective Total Abdominal Hysterectomy under General Anesthesia.
Exclusion criteria
Allergy with local anesthetics. Infection in the injection site. Coagulopathy or anticoagulant use. Morbid obesity (BMI > 35 kg/m²).
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Health services research
Study locations
Pakistan · 1 center
- SKBZN CMH Muzaffarabad — Muzaffarabad
Publications
- Korgvee A, Junttila E, Koskinen H, Huhtala H, Kalliomaki ML. Ultrasound-guided quadratus lumborum block for postoperative analgesia: A systematic review and meta-analysis. Eur J Anaesthesiol. 2021 Feb 1;38(2):115-129. doi: 10.1097/EJA.0000000000001368. PMID 33186305
- Adhikary SD, Pruett A, Forero M, Thiruvenkatarajan V. Erector spinae plane block versusquadratus lumborum block: a meta-analysis of randomized controlled trials. Reg Anesth Pain Med. 2021;46(10):854-863.
- Chavan R, Goklani A, Chavan G, Mali V. Comparison of anterior quadratus lumborum block versus lumbar erector spinae plane block for postoperative analgesia in total abdominal hysterectomy: A randomized controlled study. Pain Med. 2025;26(1):12-18
- Baran O, Sahin A, Arar C. Comparative efficacy of erector spinae plane and quadratus lumborum blocks in managing postoperative pain for total abdominal hysterectomy: A randomized controlled trial. Medicine (Baltimore). 2024 Oct 25;103(43):e40313. doi: 10.1097/MD.0000000000040313. PMID 39470511
- Abdelaziz TSA, Abdou K, Salem M. Erector spinae plane block versus quadratus lumborum block for postoperative analgesia after abdominal hysterectomy: a randomized comparative study. Anaesth Pain Intensive Care. 2024;28(2):333-340.
- Zewdu D, Tantu T, Eanga S, Tilahun T. Analgesic efficacy of erector spinae plane block versus transversus abdominis plane block for laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trial. Front Med (Lausanne). 2024 Jul 29;11:1399253. doi: 10.3389/fmed.2024.1399253. eCollection 2024. PMID 39135713
Identifiers
NCT: NCT07480499 · ANS-2023-106-3308