Bilateral Ultrasound-Guided Intra Muscular Quadratus Lumborum Block Versus Trans Muscular Quadratus Lumborum Block for Peri-Operative Analgesia in Abdominal Surgeries in Pediatric Patients. A Comparative Controlled Randomized Study.

Bilateral Ultrasound-Guided Intra Muscular Quadratus Lumborum Block Versus Trans Muscular Quadratus Lumborum Block for Peri-Operative Analgesia in Abdominal Surgeries in Pediatric Patients. A Comparative Controlled Randomized Study.

To compare between the intra muscular quadratous lamborum and the Trans muscular quadratous lamborum in pediatric population under going abdominal surgeries regards to first request of rescue analgesia, degree of pain relief, effect on hemo dynamic stability and incidence of complications.

The investigators hypothesized that an ultrasound guided quadratous lamborum block would prove successful peri-operative analgesia for abdominal surgeries in pediatric patients, and that Intra muscular quadratous lamborum is non inferior to Trans muscular blockade with the advantage of being safer (away from the peritoneum and retroperitoneal organs) and with the assumption that sarcolemmal layer in pediatrics should not resist the diffusion of the injectant from within the muscle out, to reach the inter fascial plane where the targeted nerves are found and cause an efficient blockade.

Inclusion Criteria:

• Children age starting from 5 to 12 years.
• Genders eligible for study: both sexes.
• American Society Of Anesthesia (ASA) I-III.
• Scheduled to undergo laparoscopy.

Exclusion Criteria:

• Refusal of regional block or patients requiring emergency procedures.

  • Known Local Anesthetics drug sensitivity
  • Bleeding disorders with International Normalised Ratio (INR) > 1.5 and/or platelets < 100 000.
  • Skin lesions or wounds at site of proposed needle insertion.
  • Evidence of peritonitis or septicemia.
  • Hepatic disease or enlargement.