Abstract: Objective To investigate the application value of anterior quadratus lumborum and pudendal nerve block combined with general anesthesia in patients undergoing transvaginal total hysterectomy. 
Methods A total of 100 patients who underwent elective transvaginal total hysterectomy + vaginal anterior and posterior wall repair in our hospital were selected, and divided into the anterior quadratus lumborum and pudendal nerve block combined with general anesthesia group (QPG group, n=50) and the anterior quadratus lumborum block combined with general anesthesia group (QG group, n=50). Anesthesia condition, visual analog scale (VAS) score during exercise and at rest were observed and compared between two groups. 
Results The onset time of block in QPG group was (6.40±1.13) min, which was significantly faster than that in QG group (P＜0.05). The doses of remifentanil, propofol and CIS atracurium in QPG group were (810.12±97.55) mg, (660.74±51.21) mg and (17.80±2.21) mg, respectively, which were significantly fewer than those in QG group (P＜0.05). The cumulative dosage of patient receiving patient controlled intravenous analgesia (PCIA) within 48 h after operation, the number of effective PCIA compressions within 48 h after operation and the incidence of remedial analgesia in QPG group were (38.87±8.12) mL, (6.80±1.22) times and 4.00%, respectively, which were significantly less than those in QG group (P＜0.05). The awakening time, spontaneous expiratory recovery time and laryngeal mask removal time in QPG group were (4.20±0.97) min, (5.33±1.02) min and (5.80±1.21) min, respectively, which were significantly faster than those in QG group (P＜0.05). VAS scores at 2 h, 8 h, 12 h and 24 h after operation during exercise and at rest in QPG group were significantly lower than those in QG group (P＜0.05). 
Conclusion Anterior quadratus lumborum and pudendal nerve block combined with general anesthesia after transvaginal total hysterectomy is helpful to reduce the dosage of anesthetic drugs and improve the postoperative analgesic effect. 

Key words: transvaginal total hysterectomy, anterior quadratus lumborum block, pudendal nerve block, general anesthesia