A comparative evaluation of ultrasound guided anterior quadratus lumborum block with posterior quadratus lumborum block for total laparoscopic hysterectomy.

This prospective, randomized, double-blind, controlled clinical trial aims to compare the analgesic efficacy of two ultrasound-guided approaches of the quadratus lumborum block (QLB)—anterior  and posterior—in patients undergoing total laparoscopic hysterectomy (TLH) under general anaesthesia.

A total of 56 female patients (ASA I–II, aged 40–65 years) scheduled for elective TLH will be randomly assigned into two equal groups. Group A will receive ultrasound-guided anterior QL block, while Group B will receive posterior QL block, both using 25 mL of 0.3% ropivacaine bilaterally with 8 mg dexamethasone.

Blocks will be performed post-induction by experienced anaesthesiologists. The primary outcome is the time to first rescue analgesic requirement . Secondary outcomes include total opioid consumption within 24 hours, VAS pain scores, postoperative nausea/vomiting, sedation, and patient satisfaction scores.

The study seeks to determine whether anterior QLB provides superior postoperative analgesia and greater patient satisfaction compared to the posterior approach, potentially supporting its routine use for enhanced recovery after total laparoscopic hysterectomy.