Comaprison Between QLB and ESPB in Patients for PCNL Operation

Comparison Between Ultrasound Guided Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plane Block in Patients Undergoing Percutaneous Nephrolithotomy

comparing the subcostal oblique Quadratus Lumborum block and the Erector Spinae plane block in patients undergoing percutaneous nephrolithotomy operation to get the best and longest postoperative analgesic effect.

Here the investigators are going to compare between the Anterior approach for the subcostal oblique Quadratus Lumborum block (QLB) and the Erector Spinae Plane Block (ESPB) to determine their level of spread and their value in controlling postoperative pain in patients scheduled for Percutaneous Nephrolithotomy surgery. We hypothesized that quadratus lumborum is not inferior regarding the duration of analgesia when compared to erector spinae in patients undergoing percutaneous nephrolithotomy under general anesthesia.

Inclusion Criteria:

• Both sex
• Age: 18-60
• ASA (American Society of Anesthesiologists) class I and II
• Elective surgery
• Patients undergoing PNL surgery

Exclusion Criteria:

• Patient's refusal
• Allergy or contraindications to drugs used in the study
• Emergency surgery
• Psychiatric disorders
• Severely co-morbid patients
• Inflammation or infection over injection site
• Bleeding diathesis; INR more than 1.5 and Platelet count less than 100,000/mm3
• Peripheral neuropathy
• Obese patients BMI ≥35
• Patients on previous opioid therapy
• Pre-operative haemoglobin <10 mg/dl
• Inability to properly describe postoperative pain to investigators
• Coagulation abnormalities
• History of drug addiction or alcohol abuse
• History of Previous renal surgery