Background and Aims Pain after cesarean section (CS) has a somatic and a visceral component. Insufficient pain control in the postoperative period compromises recovery and increases the risk of developing chronic pain. The quadratus lumborum block (QL) is a fascial plane block with a potential capability to provide visceral and somatosensory analgesia. This effect is probably due to the spread of the local anesthetic beyond the transversus abdominis plane into the paravertebral space.
The aim of this study was to compare the analgesic efficacy of QL block with the transversus abdominis plane (TAP) and the ilioinguinal-iliohypogastric (IL-IH) blocks in women undergoing CS.
Methods A retrospective study was performed including women from 2015 to 2022 who underwent spinal anesthesia for CS combined with QL, TAP or IL-IH blocks for postoperative analgesia. The effectiveness of QL, TAP and IL-IH blocks was compared by using pain scores and requirement of rescue analgesia. This work was approved by the ethic committee.
Results A total of 255 women were enrolled for this study. At 24 hours after surgery, at rest, 97% of women experienced no pain or mild pain and 3% moderate pain. In movement, 75% presented no pain or mild pain, 21% moderate pain and 4% severe pain. Comparing the different blocks performed, no differences were found.
Conclusions Nerve block techniques as part of a multimodal analgesia strategy is associated with reduced pain scores in parturients undergoing CS. The results of this work suggest that QL, TAP and IL-IH blocks provide comparable postoperative analgesia.
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