https://doi.org/10.4081/aiua.2026.15675
Comparative study between ultrasound guided erector spinae block versus thoracic paravertebral block versus quadratus lamborum block for postoperative analgesia after open renal surgeries: a prospective randomized controlled study
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Published: 31 July 2026
Background: Open renal surgeries are associated with significant postoperative pain, which may delay recovery and increase opioid requirements. Ultrasound-guided regional anesthesia techniques such as erector spinae plane block (ESPB), thoracic paravertebral block (PVB), and quadratus lumborum block (QLB) have emerged as effective components of multimodal analgesia.
Objective: To compare the analgesic efficacy of ESPB, PVB, and QLB versus systemic analgesia in patients undergoing elective open renal surgeries.
Methods: This prospective, randomized, controlled study included 48 patients (ASA I-II) undergoing open renal surgery. Patients were allocated into four groups (n = 12 each): ESPB, PVB, QLB (each received 20 ml of 0.25% bupivacaine), and control (IV morphine). Postoperative pain was assessed using the visual analogue scale (VAS) at 2, 4, 6, 12, 18, and 24 hours. Total 24-hour morphine consumption and patient satisfaction were recorded.
Results: VAS scores were significantly lower in all block groups compared to the control group at all-time points (p < 0.001), with no significant differences among ESPB, PVB, and QLB. Total morphine consumption was highest in the control group (25.0 ± 4.5 mg), followed by ESPB (12.0 ± 3.2 mg), PVB (10.0 ± 2.8 mg), and QLB (8.0 ± 2.5 mg) (p < 0.001). Patient satisfaction was significantly higher in the block groups, particularly in the QLB group.
Conclusions: ESPB, PVB, and QLB provide effective postoperative analgesia and reduce opioid consumption after open renal surgeries. QLB demonstrated the most favorable opioid-sparing effect, although all techniques showed comparable analgesic efficacy.
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Ethics Approval
CRediT authorship contribution
MA, MB, AM, MA: manuscript preparation, protocol, data collection and management, manuscript editing. MH, WM, HO, TE: Data acquisition, data analysis and management, manuscript editing. ME. EM, TA: Manuscript editing, project development, data analysis, and project development. All the authors have read and approved the manuscript.
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Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author.
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