Comparison Between Ultrasound Guided Quadratus Lumborum Block and Erector Spinae Plane Block as an Analgesic Modality in Renal Transplant Donors

Regional anesthesia techniques are commonly recommended for pain management in opennephrectomy as they decrease parenteral opioid requirements and improve patientsatisfaction (Capdevila et al., 2017).Erector Spinae Plane block (ESPB), was initially described by Forero et al. (2016) foranalgesia in thoracic neuropathic pain (Forero et al., 2016) and despite its recentliterature it has also been widely used in both adults and children at deferent levelsfor deferent indications such as chronic shoulder pain (T2), thoracic surgery and breastsurgery (T4‐5) and upper abdominal surgery (T7‐8) (Chin et al., 2017a; Chin et al.,2017b), however, most of the published trials regarding its analgesic effect followingmajor open abdominal surgeries are case reports and rare. In this ultrasound‐guided (USG)approach, a local anesthetic (LA) is injected between the erector spinae muscle and thetrans‐verse process of the thoracic vertebrae leading to spread of LA cephalad, caudallyand through the paravertebral space (Forero et al., 2016; Chin et al., 2017a; Chin etal., 2017b).Quadratus Lumborum block (QLB) is a widely used as regional anesthesia technique as well.It has been used for reducing postoperative pain after cesarean section, laparotomy orlaparoscopic procedure and hip surgery (Blanco et al., 2016; McCrum et al., 2018) it wasdefined for the first time by Blanco 2007 where the LA was injected at the anterolateralaspect of the QL muscle (type I QLB) (Blanco, 2007) Later, Børglum et al. (2013) usedposterior transmuscular approach by detecting Shamrock sign and injecting the LA at theanterior aspect of the QL (type III QLB) (Børglum et al., 2013).Blanco and McDonnell, described another approach by injecting the LA at the posterioraspect of the QL muscle (type II QLB) (Blanco and McDonnell, 2013). Finally, theintramuscular QLB (type IV QLB) was performed by injecting LA directly into the QLmuscle.Hence, this study is designed to assess the efficacy of Quadratus lumborum block incomparison with erector spinae plane block in reducing post‐operative pain and additionalopioid requirement within the first 24 h in patients undergoing open nephrectomy undergeneral anaesthesia.