Effect of Bilateral Quadratus Lumborum Block Type I on Patient Satisfaction and Incidence of Chronic Postsurgical Pain Following Cesarean Section-A Randomized Controlled Trial

Marcin Mieszkowski, Marek Janiak, Michał Borys, Paweł Radkowski, Marta Mieszkowska, Yauheni Zhalniarovich and Dariusz Onichimowski
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Marcin Mieszkowski: Department of Anesthesiology and Intensive Care, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Warszawska 30, 10-082 Olsztyn, Poland
Marek Janiak: 1st Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Lindleya 4, 02-005 Warsaw, Poland
Michał Borys: 2nd Department of Anesthesiology and Intensive Care, Medical University of Lublin, 20-081 Lublin, Poland
Paweł Radkowski: Department of Anesthesiology and Intensive Care, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Warszawska 30, 10-082 Olsztyn, Poland
Marta Mieszkowska: Department of Surgery and Radiology with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland
Yauheni Zhalniarovich: Department of Surgery and Radiology with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland
Dariusz Onichimowski: Department of Anesthesiology and Intensive Care, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Warszawska 30, 10-082 Olsztyn, Poland

IJERPH, 2021, vol. 18, issue 17, 1-10

Abstract: Background: Quadratus lumborum block (QLB) provides a reduction in pain scores and opioid consumption after cesarean section (CS). Intrathecal morphine (ITM) is still considered as the gold standard of acute postoperative pain therapy, but it does have some significant side effects. The aim of this clinical study was to evaluate whether performing the quadratus lumborum block type I in patients undergoing CS would be associated with an increased satisfaction of pain therapy and a decreased incidence of chronic postsurgical pain (CPSP). Methods: Sixty patients scheduled for elective CS were enrolled. All patients received spinal anesthesia and were randomly allocated to either the QLB group (received bilateral quadratus lumborum block type I with the use of 24 m mL 0.375% ropivacaine) or the control group (received no block). The level of satisfaction was evaluated using a three-step scale and the answers provided in a questionnaire regarding the patients’ satisfaction with the method of postoperative pain treatment in the first 48 h. After a 6-month period, all patients were interviewed to evaluate the incidence and possible severity of CPSP. Results: Satisfaction scores were significantly lower in the QLB group than in the control group ( p = 0.0000). There were no significant differences between the QLB and control groups regarding the occurrence of chronic postsurgical pain after 6 months following CS ( p = 0.102). No statistical differences between the groups were recorded when we compared the results of the questionnaire after a period of 48 h from CS (the number of participants were limited in number). Conclusions: QLB type I is an analgetic option that increased the satisfaction of parturients with pain therapy after CS compared to patients who did not receive the block, and there is a tendency for a lower incidence of CPSP.

Keywords: quadratus lumborum block type I; cesarean section; ropivacaine; satisfaction; chronic postsurgical pain; multimodal analgesia (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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