Background and Aims After cesarean section (CS), moderate to severe pain scores are expected, which compromises recovery and increases the risk of developing chronic pain.
The neuraxial approach is the most frequently used technique to provide anesthesia and postoperative analgesia to the parturient. However, it is estimated that about 6% of CS are performed under general anesthesia (GA), particularly in cases where the neuraxial approach is contraindicated. In these women, peripheral nerve blocks (PNB) may play a particularly important role as part of a multimodal analgesia strategy.
This study aims to compare the effectiveness of transverses abdominis plane (TAP), quadratus lumborum (QL) and ilioinguinal-iliohypogastric blocks (IL-IH) in women undergoing GA for CS.
Methods A retrospective study was performed including women from 2013 to 2022 who underwent GA for CS combined with a PNB for postoperative analgesia. The efficacy of TAP, QL and IL-IH blocks was compared. This work was approved by the ethics committee.
Results A total of 28 women were enrolled for this study. At 24 hours after surgery, at rest, 75% of women experienced no pain, 14% mild pain and 11% moderate pain. Evaluating the presence of pain with movement, 11% presented no pain, 61% mild pain, 21% moderate pain and 7% severe pain. Comparing the different types of PNB performed, no differences were found.
Conclusions PNB can be an important tool in managing postoperative analgesia in women undergoing CS, particularly when neuraxial analgesia cannot be realized. The results of this work suggest that QL, TAP and IL-IH blocks provide comparable postoperative analgesia.
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