Abstract

Background: Regional anesthesia techniques have gained prominence in perioperative pain management for renal surgeries. Both erector spinae plane (ESP) block and anterior quadratus lumborum (QLB) block offer promising alternatives for postoperative analgesia.
Objective: To compare and evaluate the analgesic efficacy of ultrasound-guided ESP block versus anterior QLB using levobupivacaine in patients undergoing renal surgeries.
Methods: This prospective, randomized, double-blind study included 80 patients (ASA I-III) scheduled for elective renal surgeries. Patients were randomly allocated into two groups: Group E (ESP block, n=40) and Group Q (anterior QLB, n=40). Both groups received 0.25% levobupivacaine (20ml) under ultrasound guidance. Primary outcomes included postoperative pain scores using Visual Analog Scale (VAS) at rest and movement at 2, 4, 8, 12, and 24 hours. Secondary outcomes included time to first analgesic request, total morphine consumption, patient satisfaction scores, and complications.
Results: Both groups demonstrated significant reduction in postoperative pain scores compared to historical controls. Group E showed statistically significant lower VAS scores at rest at 2 hours (2.1±0.8 vs 2.8±1.1, p=0.002) and 4 hours (2.3±0.9 vs 3.1±1.2, p=0.001) compared to Group Q. Time to first analgesic request was longer in Group E (8.2±2.1 hours) versus Group Q (6.4±1.8 hours, p=0.001). Total 24-hour morphine consumption was significantly lower in Group E (12.4±3.2mg) compared to Group Q (16.8±4.1mg, p<0.001). Patient satisfaction scores were higher in Group E (8.7±1.1) versus Group Q (7.9±1.3, p=0.003). No major complications were reported in either group.
Conclusion: ESP block provides superior analgesic efficacy compared to anterior QLB in renal surgeries, with longer duration of analgesia, reduced opioid consumption, and higher patient satisfaction scores. Both techniques demonstrate excellent safety profiles.