Abstract
Acute pain intensity related to cesarean section (CS) may be extensive and is often underestimated. This may influence mothers’ quality of life and their children’s development. Regional analgesia techniques that include transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) have proven their efficacy in the postoperative period after CS. Although several randomized controlled studies and one meta-analysis have investigated the utility of TAPB and QLB in the reduction of acute and chronic pain after CS, only one study directly compared both types of regional blocks and revealed superiority of QLB over TAPB. Our study aimed to reevaluate the effectiveness of transversus TAPB and QLB in controlling acute postoperative pain after CS. We recruited 197 women with singleton pregnancies undergoing CS under spinal anesthesia. The patients were randomized to receive either TAPB or QLB after CS. The acute postoperative pain was evaluated using the visual analog scale (VAS) at 2, 4, 8, 12 and 24 h after the operation. No significant difference in acute postoperative pain intensity between the groups was found. The patients who received TAPB had a higher demand for supplemental morphine injections (p < 0.039). In our study, none of the evaluated regional blocks demonstrated an advantage over the other regarding acute postoperative pain management.
Highlights
The number of the cesarean deliveries has almost doubled between 2000 and 2015 [1].The highest rise of cesarean sections (CSs) in recent years was observed in Eastern Europe and South and Central Asia
The authors concluded that ineffective pain treatment after CS in comparison with large abdominal/thoracic procedures may be attributed to the use of regional anesthesia techniques, especially epidural in the latter
We considered five measurements of pain severity, which were obtained during the first 24 h
Summary
The number of the cesarean deliveries has almost doubled between 2000 and 2015 [1]. The highest rise of cesarean sections (CSs) in recent years was observed in Eastern Europe and South and Central Asia. In Poland, the percentage of childbirth by cesarean section reached 38.9% of all deliveries in 2018 [2]. Acute pain intensity related to this procedure is often underestimated. Gerbershagen et al noted that of 179 types of surgical procedures that were performed in Germany, the cesarean delivery was graded as the ninth in terms of postoperative pain intensity [3]. The authors concluded that ineffective pain treatment after CS in comparison with large abdominal/thoracic procedures may be attributed to the use of regional anesthesia techniques, especially epidural in the latter
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