Postoperative analgesia efficacy of quadratus lumborum block versus transversus abdominis plane block in patients undergoing caesarean section

Abstract

Objective To compare the postoperative analgesic effect of ultrasound-guided quadratus lumborum block(QLB) and transversus abdominis plane block(TAPB) block in caesarean delivery with median incision in the lower abdomen. Methods Eighty patients undergoing caesarean delivery with the median incision of the lower abdomen, classified as ASA Ⅰ or Ⅱ, were randomly divided into QLB group(group Q, n=40) and TAPB group (group T, n=40). Puerperants were scheduled for caesarean delivery under combined spinal and epidural anesthesia with median incision in the lower abdomen. After surgery, patients in group Q received ultrasound-guided QLB with bilateral ropivacaine(20 ml of 0.375%) injection into thoracolumbar fascia behind quadratus lumborum. Patients in group T received ultrasound-guided TAPB with ropivacaine(20 ml of 0.375%) bilaterally. The resting and exercise VAS scores and the consumption of sufentanil 4, 8, 12, 24, 48 h after operation were recorded. The incidences of postoperative adverse reactions and patients' satisfaction with postoperative analgesia were also documented. Results There was no significant difference in postoperative resting VAS scores between the two groups(P>0.05). The exercise VAS scores 8, 12, 24, 48 h after operation and the consumption of sufentanil in group Q were significantly lower than those in group T(P<0.05). Patients in group Q had lower incidence of adverse reactions(P<0.05). Conclusions Ultrasound-guided bilateral QLB with ropivacaine can reduce the consumption of opioid drugs after caesarean delivery, reduce the exercise VAS score, and improve patients' satisfaction. Key words: Quadratus lumborum block; Caesarean section; Postoperative analgesia