QL Block Versus EO Plane Block for Analgesia After Open Nephrectomy

This prospective randomized clinical trial aims to compare two ultrasound-guided regional anesthesia techniques, the transmuscular quadratus lumborum (QL) block and the external oblique (EO) plane block, for pain relief after open nephrectomy. Open nephrectomy is a major surgical procedure that can cause significant postoperative pain and may require opioid medications for adequate pain control. Adult patients undergoing open nephrectomy at the National Cancer Institute, Cairo University, who meet the study eligibility criteria will be randomly assigned to receive either a QL block or an EO plane block before surgery. Both techniques will be performed under ultrasound guidance using bupivacaine in addition to standardized general anesthesia and multimodal postoperative analgesia. The main purpose of the study is to determine whether the QL block provides better postoperative analgesia than the EO plane block. The primary outcome will be the total amount of intravenous morphine consumed during the first 24 hours after surgery. Secondary outcomes will include postoperative pain scores, time to first request for rescue analgesia, hemodynamic changes, recovery time, patient satisfaction, and adverse effects related to analgesia or the regional anesthesia techniques. A total of 54 patients will be enrolled and randomly allocated equally between the two treatment groups.