Quadratus Lumborum Block vs Transversus Abdominis Plane Block in Bladder Cancer Surgeries

Transversus abdominis plane (TAP) block can be used to provide effective analgesia during the postoperative period following a range of surgeries. TAP block administers local anesthetics between the T6 to L1 spinal nerve roots to stop the nerve signal and to alleviate pain for abdominal procedures 4, 5. The viscera are innervated by the vagal nerve (parasympathetic innervation) and by the splanchnic nerves (sympathetic innervation). The splanchnic nerves carry both visceral efferent and afferent nerve fibers. The sensory (or afferent) part of the splanchnic nerves reach the spinal column at certain spinal segments, It is possible to block central visceral pain conduction with thoracic paravertebral blockade or maybe even with the novel quadratus lumborum (QL) block. The effect of the QL block is believed to result from a spread of LA from its lumbar deposition cranially into the thoracic paravertebral space (TPVS), since Carney et al found traces of contrast agent in the TPVS following application of this block. Hence, the QL block would seem to be able to alleviate both somatic and visceral pain.10 The aim of this study is to compare between quadratus lumborum block, transversus abdominis plane block regarding perioperative analgesia after bladder cancer surgeries by measuring intraoperative hemodynamics, postoperative pain scores and morphine consumption in the first 24 h postoperative.

Sex

All

Minimum age

20 Years

Maximum age

80 Years

Inclusion Criteria:

* Age of the patients between 20 to 80 years.
* ASA physical status II -III
* Elective bladder cancer operations.

Exclusion Criteria:

* Patient refusal
* Local infection at the site of injection
* Allergy to study medications
* Sepsis
* Anatomic abnormalities
* Systemic anticoagulation or coagulopathy
* Inability to comprehend or participate in pain scoring system