Ultrasound guided quadratus lumborum block and transversus abdominis plane block for postoperative analgesia after lower segment caesarean section under spinal anesthesia: A prospective observational study

Abstract

Background: Caesarean section being a major surgical procedure is associated with substantial postoperative discomfort and moderate to severe pain for 48 hours postoperatively. This prospective study was undertaken to observe the ultrasound guided quadratus lumborum block and transversus abdominis plane block for postoperative analgesia after lower segment caesarean section under spinal anesthesia.\nMaterials and Methods: Hundred patients belonging to ASA class I&II and a normal singleton pregnancy with a gestation of at least 37 weeks posted for elective caesarean delivery under spinal anesthesia were selected. The patients who had received either TAP block or QL block were assigned two groups. The patients who had received TAP block were assigned group A and the patients who had received QL block were assigned group B.\nResults: The overall VAS score in group B was lower than in group A. The duration of analgesia in Group A ranged from 6-12 hours with a mean duration of 8.5±1.998 hours. In Group B the duration ranged from 9-24 hours with a mean duration of 16.5±3.096 hours. The difference in duration of analgesia between the two groups was statistically significant. In group A the mean analgesic consumption dose was 1.07±0.264\ngrams at 12 hours, 2.11±0.317 grams at 24 hours and 2.67±0.673 at 48 hours. In group B it was 0.43±0.501 grams at 12 hours, 1.35±0.567 grams at 24 hours and 1.65±0.604 grams at 48 hours. The difference was statistically significant\nConclusion: It can be concluded that Ultrasound Guided nerve blocks (TAP block and QL block) can be used as a part of multimodal analgesia for better postoperative pain relief in lower abdominal surgeries like LSCS especially when given before the resolution of spinal anaesthesia. Further it was observed that QLB was superior to TAP block in terms of better pain control (duration and quality) as shown by lower VAS score, demand for the first rescue analgesia which was delayed and total consumption of rescue