الفهرس 
ANATOMY OF THE ABDOMINAL WALLOnly 14 pages are availabe for public view
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Abstract
Background: The quadratus lumborum (QL) block is a recently introduced abdominal truncal
block, used for somatic and visceral analgesia in abdomen surgeries.Aim of the work: To compare
between caudal block and ultrasound guided quadratus lumborum block as regard degree of pain
relief, accuracy of block, effect on hemodynamic stability and incidence of complications in lower
abdominal surgeries . Patients and methods: Fifty two patients ranging from one to seven years of
age of both genders, scheduled for unilateral lower abdominal surgery were randomized into 2
study groups. group QL — Unilateral quadratus lumborum block (n= 26) group C — Caudal
block (n= 26). Inhalational induction of general anesthesia (GA) was performed . group C:
Children received caudal block with 1 ml/kg of bupivacaine 0.25%. group QL: Ultrasound guided
quadratus lumborum block was done. The local anesthetic was injected as a bolus of 0.5 ml/Kg
bupivacaine 0.25%. Quality of analgesia was assessed using a FLACC scale at 30 minutes and at 1,
2, 4, 6, 12, and 24 hours postoperatively .Hemodynamic parameters (heart rate, systolic and
diastolic arterial blood pressure) were recorded preoperatively and every 15 min till the end of
surgery. Incidence of complications in the form of hemodynamic instability, injury to the
underlying structures (injury to the liver or a viscous), and hematoma formation as recorded under
ultrasound guidance, and signs of local anesthetics toxicity The general satisfaction of parents were
also recorded . Results: As regards hemodynamic parameters ,there was no statistically significant
difference between the two groups (p value > 0.05) ,there was no statistically difference in the
severity of postoperative pain between both study groups up to 24 hours postoperatively. The time
till first request for analgesia postoperatively was statistically longer in the QL group compared to
C group. Parents of the QL block group showed a higher level of satisfaction than the caudal block
group. No intraoperative complications were detected Conclusion: the QL block provided longer
and more effective postoperative analgesia compared with the caudal block.