Bilateral ultrasound-guided quadratus lumborum block versus bilateral transversus abdominis plane block for postoperative analgesia after cesarean section

Abstract

Background For mothers caring for newborns, adequate pain control after cesarean section is critical, as is early ambulation to prevent thromboembolism and chronic abdominal and pelvic pain. Aim The primary goal of the research is to compare the effectiveness of ultrasound-guided quadratus lumborum block (QLB) versus transversus abdominis plane (TAP) block for postoperative analgesia and opioid consumption after a cesarean section. The secondary goal of the research is to assess the time required for each technique and postoperative complications and patient satisfaction in each group. Patients and methods Current research occurred in Elshatby University Hospital on 40 American Society of Anesthesiologists I or II studied cases with a gestation of at least 37 weeks (according to sample size calculation) scheduled for elective cesarean section. Results Comparing the time of analgesia between the two groups was longer in the QLB1 group than the control group (P≤0.001). The total amount of rescue analgesia (nalbuphine) consumption ranged between 0 and 6 mg with a mean value of 0.60±1.85 mg/24 h in the QLB1 group, and between 0 and 12 mg with a mean value of 8.40±5.30 mg/24 h in TAP block group. The total amount of postoperative nalbuphine consumption was greater in the TAP block group compared with the QLB1 group (P<0.001). Patient satisfaction with pain control has been assessed on four-point scale like: excellent, good, fair and poor. Comparison between the two groups showed significantly better patient satisfaction in QLB1 group compared with the TAP block group where the P value was 0.016. Conclusion From the present research, the following can be concluded: ultrasound-guided QLB is a more influential method than TAP block for postoperative analgesia in studied cases undergoing cesarean section as it is more effective in reducing both somatic and visceral pain. Ultrasound-guided QLB is associated with a decrease in total opioid consumption, longer time of analgesia and greater studied case satisfaction.