QL Block Versus EO Plane Block for Analgesia After Open Nephrectomy

The study is a prospective, randomized clinical trial designed to compare the analgesicefficacy of the transmuscular quadratus lumborum block with the external oblique planeblock in adult patients undergoing open nephrectomy.Open nephrectomy is associated with substantial postoperative pain because of the extentof the surgical incision, muscular dissection, and manipulation of retroperitonealstructures. Effective postoperative analgesia is important to facilitate recovery,mobilization, respiratory function, and patient comfort while minimizing opioidrequirements.The quadratus lumborum block is a posterior abdominal wall fascial plane block in whichlocal anesthetic is deposited in relation to the quadratus lumborum muscle. The techniquemay provide analgesia over several thoracoabdominal dermatomes and may have both somaticand visceral analgesic effects. The external oblique plane block is a more superficialfascial plane technique that targets the lateral abdominal wall and may provide effectivesomatic analgesia.Eligible patients will be randomly allocated in a 1:1 ratio to receive either atransmuscular QL block or an EO plane block before induction of general anesthesia. Allpatients will receive standardized general anesthesia and multimodal postoperativeanalgesia. The regional blocks will be performed under ultrasound guidance by anexperienced anesthesiologist.The primary outcome is total intravenous morphine consumption during the first 24postoperative hours. Secondary outcomes include pain intensity at predefinedpostoperative time points, both at rest and with movement; time to first request forrescue analgesia; intraoperative and postoperative hemodynamic changes; recovery time;patient satisfaction; and adverse effects, including nausea, vomiting, respiratorydepression, and complications related to the regional anesthesia technique.The study will evaluate whether the QL block provides superior postoperative analgesiaand opioid‐sparing effects compared with the EO plane block following open nephrectomy.