Comparison of ultrasound-guided quadratus lumborum block with iliohypogastric/ilioinguinal nerve block for postoperative pain after cesarean section

Abstract

Objective To observe the postoperative analgesic effects of quadratus lumborum block (QLB) and iliohypogastric/ilioinguinal nerve (IH/II) block after cesarean section. Methods Ninety puerperants, undergoing caesarean section, ASAⅠ/Ⅱ, were randomized into routine intravenous analgesia group (group R), quadratus lumborum block group (group QLB) and iliohypogastric/ilioinguinal nerve block group (group IH/II), thirty cases in each group in the Department of Anesthesiology, Beijing Haidian Maternal & Child Health Hospital from January 2018 to May 2018. Ultrasound-guided QLB and IH/II block were performed at the end of operation and 0.25% ropivacaine hydrochloride 20 ml was injected. Postoperative NRS and the consumption of sufentanil were recorded at 0-2 h, 2-4 h, 4-8 h, 8-12 h, 12-24 h, 24-48 h. Postoperative nausea, vomiting, dizziness and pruritus were recorded. Results The dose of sufentanil consumption was lower in group QLB than that in group R (P<0.05) at 2-48 h, and lower in group IH/II than that in group R (P<0.05) at 4-24 h, and lower in group QLB than that in group IH/II at 4-24 h. There was no difference of NRS at rest among the three groups after the operation. NRS was lower during uterine contraction in group QLB than that in group R and group IH/II at the time of 4, 8, 12, 24 h after the operation (P<0.05). No side effects were found such as postoperative nausea, vomiting, dizziness and pruritus in the three groups. Conclusion Both ultrasound-guided QLB and IH/II nerve block can provide good analgesic effect after the operation, and decrease the postoperative dosage of sufentanil. The effect of QLB is better on relieving the uterine contraction pain. Key words: Quadratus lumborum block; Iliohypogastric/ilioinguinal nerve; Nerve block; Cesarean section; Pain, postoperative; Analgesia, patient-controlled