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Postoperative analgesic efficacy of quadratus lumborum block in patients undergoing laparoscopic cholecystectomy: A retrospective study

Background: Patients undergoing laparoscopic cholecystectomy (LC) often complain of pain in the postoperative period despite intravenous analgesic administration. Systemic analgesia is also associated with side effects such as postoperative nausea and vomiting, thus adding to patient's discomfort. Posterior quadratus lumborum (QL) block has been studied to provide adequate analgesia in this set of patients. We retrospectively studied the efficacy of posterior QL block in LC patients and assessed them for chronic pain. Methods: Records of patients meeting inclusion criteria were taken. Standard multimodal analgesia as per the institute protocol was performed in all patients. Posterior QL block was performed under ultrasound guidance in test group, while control group received parenteral analgesia alone. Measurements: Static and dynamic Numeric Rating Scale (NRS) were measured at different time intervals during the first 24 postoperative h and time to rescue analgesia was noted. Assessment of chronic pain was done at the same time for all the patients. Side effect profile of both the groups was compared. Results: Static and dynamic pain scores were compared between block and control groups at immediate postoperative time period, 3 h, 12 h, and 24 h and statistically significant difference was noted with lower scores in test group as compared to control group at all four time points (P < 0.05). None of the patients in test group suffered chronic pain, while 33.3% patients in control group had chronic pain. Conclusion: Posterior QL block is an effective analgesia option for LC patients with less incidence of side effects. It should be performed more frequently as it is effective in reducing acute and probably chronic pain too in LC patients.