Effects of TAP and QLB-1 Blocks on Opioid Consumption

Laparoscopic cholecystectomy is associated with less pain than open surgery and a shorter recovery time. While the type of pain experienced after laparoscopy differs from that experienced after laparotomy, it is predominantly parietal pain (originating from the abdominal wall). However, patients also report visceral pain due to pneumoperitoneum. Various analgesic procedures, including nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and regional anesthesia techniques, are employed as part of multimodal analgesia for postoperative pain. Regional anesthesia techniques for abdominal surgery include thoracic epidural analgesia, paravertebral block, and transversus abdominis plane (TAP) block. TAP block, one of the truncal blocks, has been utilized in numerous studies in the literature for the management of postoperative pain following abdominal surgery. TAPB is a nerve block technique that blocks sensory nerves by injecting local anesthetic into the plane between the transverse abdominis and internal oblique muscles. Although TAPB can effectively relieve somatic pain in patients undergoing minimally invasive laparoscopic surgery, it may not be suitable for visceral analgesia. Another truncal block that has gained recent attention is the Quadratus Lumborum Block (QLB). QLB is another nerve block technique that blocks sensory nerves by injecting local anesthetic into the interfascial plane between the quadratus lumborum and psoas muscles. QLB offers several advantages, including the ability to provide both somatic and visceral analgesia. This comprehensive approach can result in more effective postoperative analgesia during laparoscopic surgical procedures. Additionally, the use of TAPB or QLB may reduce opioid consumption, potentially improving analgesia in laparoscopic surgeries. The quadratus lumborum muscle can be blocked in four different ways: lateral, posterior, anterior, and intramuscular. In our study, the lateral quadratus lumborum block was the preferred