This retrospective observational study evaluates the effects of different Quadratus Lumborum Block (QLB) techniques on postoperative recovery and total opioid consumption in patients undergoing radical cystectomy under general anesthesia. The study will analyze intraoperative and postoperative patient records from October 15, 2023, to October 15, 2024, at Tekirdağ Namık Kemal University Hospital.

Patients who received anterior or posterior QLB for postoperative analgesia will be included. Data collection will involve demographic information, total opioid consumption (morphine milligram equivalents), recovery quality scores (QoR-15), postoperative pain scores (Visual Analog Scale, VAS), time to first rescue analgesic administration, frequency of rescue analgesic use, and incidence of postoperative nausea and vomiting (PONV).

The retrospective analysis will compare the two QLB techniques to determine if there is a significant difference in postoperative opioid consumption and recovery quality. Statistical methods will be used to assess pain scores over time, opioid consumption, and overall recovery quality.

Postoperative pain management plays a crucial role in optimizing recovery after radical cystectomy, as inadequate pain control can lead to increased opioid consumption and delayed rehabilitation. This retrospective observational study examines the effects of two different Quadratus Lumborum Block (QLB) techniques-anterior and posterior approaches-on postoperative pain and opioid consumption.

The study includes patients who underwent radical cystectomy under general anesthesia at Tekirdağ Namık Kemal University Hospital between October 15, 2023, and October 15, 2024. The primary focus is to compare total opioid consumption (morphine milligram equivalents) within the first 24 hours after surgery between the two groups.

Secondary outcomes include:

• Pain scores at multiple time points (0, 2, 6, 12, 24 hours), measured using the Visual Analog Scale (VAS)
• Postoperative recovery quality scores (QoR-15)
• Time to first rescue analgesic administration
• Frequency of rescue analgesic use
• Incidence of postoperative nausea and vomiting (PONV)

Data will be collected from intraoperative and postoperative patient records. Statistical analysis will compare anterior vs. posterior QLB techniques, evaluating differences in postoperative opioid consumption, pain relief efficacy, and recovery quality (QoR-15 scores).

This study aims to provide evidence-based insights into the use of regional anesthesia techniques for radical cystectomy patients, supporting the refinement of multimodal analgesia strategies to optimize pain management and minimize opioid exposure.

Inclusion Criteria:

1. Patients who underwent radical cystectomy under general anesthesia between October 15, 2023, and October 15, 2024.
2. Patients who received anterior or posterior quadratus lumborum block (QLB) for postoperative analgesia.
3. Age: 18-65 years.
4. ASA Physical Status Classification: I-III.
5. BMI < 35 kg/m².
6. Complete medical records available for retrospective review.

Exclusion Criteria:

1. Patients who received a different postoperative analgesia technique (e.g., epidural, TAP block).
2. Incomplete or missing medical records.
3. Psychiatric disorders that could affect pain perception and reporting.
4. Coagulopathy or bleeding disorders.
5. Hepatic or renal failure.
6. Chronic opioid use before surgery.
7. Patients who required unplanned conversion to open surgery.

This study includes adult patients (18-65 years old) who underwent radical cystectomy under general anesthesia at Tekirdağ Namık Kemal University Hospital between October 15, 2023, and October 15, 2024. Patients were retrospectively selected based on the administration of anterior or posterior Quadratus Lumborum Block (QLB) for postoperative analgesia. Patients with complete medical records were included, while those with missing data, coagulopathy, chronic opioid use, or unplanned open surgery conversion were excluded.