# Effects of Erector Spinae Plane Block and Quadratus Lumborum Block on Postoperative Opioid Consumption in Laparoscopic Kidney Surgery: A Randomized Controlled Clinical Trial

## TL;DR

This study compares two regional anesthesia techniques for laparoscopic kidney surgery and finds they equally reduce opioid use and postoperative pain.

## Contribution

The study provides new evidence comparing the effectiveness of erector spinae plane and quadratus lumborum blocks in reducing opioid consumption after laparoscopic kidney surgery.

## Key findings

- Both ESP and QLB blocks similarly reduced opioid consumption in patients undergoing laparoscopic kidney surgery.
- No significant differences in pain scores or opioid use were observed between the two block techniques.
- Both techniques are safe and effective for multimodal analgesia in this surgical context.

## Abstract

The quadratus lumborum block (QLB) and erector spinae plane (ESP) block are relatively new regional analgesic techniques that provide analgesia to the abdominal wall and reduce postoperative opioid consumption. We compared the effectiveness of ultrasound-guided bilateral ESP block versus bilateral QLB in patients undergoing laparoscopic kidney surgery.

Adult patients who underwent laparoscopic nephrectomy or nephron-sparing surgery (NSS) within the study period were included. Patients were randomly assigned to one of two groups: group I received an ultrasound-guided ESP block with 30 mL of 0.35% ropivacaine on each side and group II received an ultrasound-guided QLB 1 with 30 mL of 0.35% ropivacaine on each side.

A total of 84 patients were included, with 45 patients in the ESP block group and 39 in the QLB group. The mean dosage of oxycodone in the ESP block group was 22.66 mg and in the QLB group was 22.66 mg. There was no difference in oxycodone consumption within the first 24 h after surgery between the groups (p=0.77).

The effect of ultrasound-guided bilateral QLB and ESP blocks in patients undergoing laparoscopic kidney surgery was found to be similar in terms of postoperative pain and opioid consumption. There were no significant differences between the blocks in opioid consumption or pain scores. Both techniques appear to be effective and safe components of multimodal analgesia strategy for laparoscopic nephrectomy.

ClinicalTrials.gov identifier: NCT05446727