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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionApplication for ESRA Abstract PrizesBackground and Aims Quadratus lumborum (QL) blocks have become an important part of multimodality analgesia protocols in abdominal surgeries.This study aimed to compare the analgesic efficacy of QL type 1 (QLB1) block alone with the combination of QL types 1 and 2 (QLB1+2) in patients undergoing open gynecologic surgery under general anesthesia.Methods In this prospective, randomized study,72 patients undergoing elective open gynecologic surgery were divided into two groups:QLB1 (n=36) and QLB1+2 (n=36) block.All patients underwent general anesthesia.Postoperative evaluations;Visual analog scale (VAS) pain scores at 0,2,6,12 and 24 hours included total opioid consumption,number of patient-controlled analgesia requests, time to first non-steroidal anti-inflammatory drug (NSAID) use and patient satisfaction scores.Results There was a difference in VAS scores at 0 (6.35±1.08 vs 7.17±1.09, p< 0.003) and 6 hours (3.91±1.07 vs 4.55±1.09, p< 0.022) postoperatively between the two block groups. There was no difference in VAS between the two block groups at other times. Between the two block groups, pca total consumption (204.4±114.72 mg vs 264±114.94 mg, p<0.04), pca demand (20.2±19.91174 vs 28.44±19.83246, P<0.013) and first NSAID application time were longer in the QLB1+2 group (p<0.016).Satisfaction was higher in the QLB 1+2 group (4.29±0.640387503 vs 3.94±0.635502193, p<0.005).Abstract P326 Figure 1Quadratus lumborum block 1–2Abstract P326 Figure 2qlb block procedureConclusions The combination of quadratus lumborum type 1 and 2 blocks provides more effective postoperative analgesia than type 1 block application alone.This method,which results in a decrease in pain scores, a decrease in opioid requirements,a delay in the need for rescue analgesics, and an increase in patient satisfaction,can be considered an effective analgesia strategy in open gynecological surgeries.