Comparing the Efficacy of Epidural and Quadratus Lumborum Analgesia After Open Nephrectomy Surgery

QL blocks with a single shot and catheters infusions may be an alternative to epidural
analgesia. However, the relative efficacy, safety, and cost of the two approaches remain
unclear.

Epidural analgesia is frequently used as a component of multimodal analgesia for thoracic and
abdominal surgery. QL block has been introduced recently as a component of multimodal
analgesia for lower thoracic and abdominal surgery. In general, insertion of QL catheter is
easier and safer than insertion of epidural catheters. QL catheter management is also less
complicated than epidural analgesia (fewer catheter displacements and less hemodynamic
compromise) and decreases the level of complexity in postoperative care. Our hypothesis is
that the subcostal QL approach with a continuous catheter is non-inferior to epidural
analgesia for pain control and opioid consumption in patients having open partial nephrectomy
procedure.

Inclusion Criteria:

Adults having for open unilateral partial nephrectomy surgery.

Exclusion Criteria:

1. Pregnancy 2. Intolerance or allergy to opioids 3. Previous radical nephrectomy
surgery/midline incision 4. Contraindication to epidural analgesia 5. Contraindications to
QL block 6. Chronic pain characterized by: i.Opioids use for more than 30 consecutive days
within the 3 preoperative months at the dose equal or greater than equivalent of 15 mg of
morphine ii.Abdominal pain for more than 6 months, present most days of the week-