Erector Spınae Plane Block and Transmuscular Quadratus Lumborum Block In Kıdney Transplantatıon

Under general anesthesia, patients in the ESP group will be positioned in the left or right lateral decubitus position, depending on the side of the surgical procedure. After the T10 spinous process is identified by manual examination, sterile conditions will be established. The transverse process and erector spinae muscles will be visualized using an ultrasound probe. Using an in-plane technique, 20 ml of 0.25% bupivacaine will be injected between the transverse process and erector spinae muscles using a 22-gauge blocking needle.

Following standard anesthesia monitoring, patients will be placed in the lateral decubitus position. After the field is sterilized, a 2-5 MHz convex ultrasound probe (Samsung, HM70 EVO) will be placed between the iliac crest and costal arch at the level of the posterior axillary line. The transverse process of the L4 vertebra, erector spinae, QL, and PM muscles will be visualized. After inducing local anesthesia with 2% lidocaine (2 ml), a blocking needle (22G\*100 mm, Braun) will be advanced from posterolateral to anteromedial, inserting it between the QL and PM muscles, and 20 ml of 0.25% bupivacaine will be injected.