The Effectiveness of Transversus Abdominis Plane and Quadratus Lumborum Blocks in Acute Postoperative Pain Following Cesarean Section—A Randomized, Single-Blind, Controlled Trial

Michał Borys, Beata Potręć-Studzińska, Paweł Kutnik, Justyna Sysiak-Sławecka, Elżbieta Rypulak, Tomasz Gęca, Anna Kwaśniewska, Mirosław Czuczwar and Paweł Piwowarczyk
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Michał Borys: II Department of Anesthesiology and Intensive Care, Medical University of Lublin, Ul. Staszica 16, 20-081 Lublin, Poland
Beata Potręć-Studzińska: II Department of Anesthesiology and Intensive Care, Medical University of Lublin, Ul. Staszica 16, 20-081 Lublin, Poland
Paweł Kutnik: II Department of Anesthesiology and Intensive Care, Medical University of Lublin, Ul. Staszica 16, 20-081 Lublin, Poland
Justyna Sysiak-Sławecka: II Department of Anesthesiology and Intensive Care, Medical University of Lublin, Ul. Staszica 16, 20-081 Lublin, Poland
Elżbieta Rypulak: II Department of Anesthesiology and Intensive Care, Medical University of Lublin, Ul. Staszica 16, 20-081 Lublin, Poland
Tomasz Gęca: Department of Obstetrics and Pathology of Pregnancy, Medical University of Lublin, 20-081 Lublin, Poland
Anna Kwaśniewska: Department of Obstetrics and Pathology of Pregnancy, Medical University of Lublin, 20-081 Lublin, Poland
Mirosław Czuczwar: II Department of Anesthesiology and Intensive Care, Medical University of Lublin, Ul. Staszica 16, 20-081 Lublin, Poland
Paweł Piwowarczyk: II Department of Anesthesiology and Intensive Care, Medical University of Lublin, Ul. Staszica 16, 20-081 Lublin, Poland

IJERPH, 2021, vol. 18, issue 13, 1-10

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.

Keywords: pain; cesarean section; analgesia; quadratus abdominis block; transverse abdominis plane block (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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