A study to compare ultrasound guided quadratus luborum block and erector spinae block for post operative analgesia in patient undergoing percutaneous nephrolithotomy - A prospective randomised double blind study

The ethical committee approval of the institute will be taken. Informed consent will be obtained from all the patients A prospective randomized double blind study. All the patients will undergo thorough preoperative evaluation, which include history taking, physical examination and relevant laboratory investigations. Patients having any of the exclusion criteria will be excluded from the study. Patients willing to be part of the study will be randomly allocated in to 2 groups which will be computer generated. Patient will be educated about VAS score in the pre operative visit. All patients will be informed about the potential benefits and complications after the study will be thoroughly explained. Standard monitors like pulse oximeter, ECG, and NIBP recording will be attached to all patients and baseline parameters such as pulse rate, blood pressure and oxygen saturation will be noted. Anaesthesia induction will be delivered with fentanyl 2mcg/kg, propofol 2mg/kg and vecuronium 0.1mg/kg, maintenance by isoflurane and 50% nitrous and 50%oxygen.Patient will be intubated with appropriate size endotracheal tube. Intravenous Ondansetron 4mg and Dexamethasone 4mg will be given to all the patients.. After administering general anaesthesia in supine position, the patient will be turned to lateral position. A total of 60 patients aged between 18 and 75 years. ASA grading 1, 2 and 3 will be selected allocated to 2 groups randomly- QLB Group: All members of this group will recive quadratus lumborum block on side of surgery. The QLB will performed by using bupivacaine 0.25% (20 ml on side of surgery). ESB Group: All members of this group will erector spinae block on side of surgery. The ESB was performed by using bupivacaine 0.25% (20 ml on side of surgery). Heart rate, blood pressure, oxygen saturation will be monitored every 5 min for initial 30 min and later on every 15 min till the end of surgery. Post operatively patient will be kept in recovery room for 2 hours. Heart rate, blood pressure, oxygen saturation will be measured and VAS score will be noted at 1,2, 4, 8, 12,16 and 24 hours after the procedure. If pain score ≥ 3, then patient will be given intravenous Paracetamol 1g iv (up to 3 doses /day). If pain persists after 30 minutes of paracetamol injection, then intravenous Tramadol 50mg will be given (up to 2 doses/day). Time from study drug injection till first dose of rescue analgesia is considered as duration of analgesia. Total number of rescue analgesic doses in 24 hours will be recorded.