Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study

Michał Borys, Aleksandra Zamaro, Beata Horeczy, Ewa Gęszka, Marek Janiak, Piotr Węgrzyn, Mirosław Czuczwar and Paweł Piwowarczyk
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Michał Borys: Second Department of Anesthesia and Intensive Care, Medical University of Lublin, 20-059 Lublin, Poland
Aleksandra Zamaro: Department of Obstetrics and Perinatology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warszawa, Poland
Beata Horeczy: Anesthesiology and Intensive Care Department with the Center for Acute Poisoning, St. Jadwiga Provincial Clinical Hospital, 35-301 Rzeszów, Poland
Ewa Gęszka: Department of Obstetrics and Perinatology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warszawa, Poland
Marek Janiak: First Department of Anesthesiology and Intensive Care, Medical University of Warsaw, 02-091 Warszawa, Poland
Piotr Węgrzyn: Department of Obstetrics and Perinatology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warszawa, Poland
Mirosław Czuczwar: Second Department of Anesthesia and Intensive Care, Medical University of Lublin, 20-059 Lublin, Poland
Paweł Piwowarczyk: Second Department of Anesthesia and Intensive Care, Medical University of Lublin, 20-059 Lublin, Poland

IJERPH, 2021, vol. 18, issue 7, 1-12

Abstract: Background: Severe postoperative pain is a significant problem after cesarean sections. Methods: This study was a randomized, controlled trial of 105 patients conducted in two hospitals. All patients were anesthetized spinally for elective cesarean section. Each participant was randomly allocated to one of three study groups: the quadratus lumborum block (QLB) group, the transversus abdominis plane block (TAPB) group, or the control (CON) group. The primary outcome of this study determined acute pain intensity on the visual analog scale (VAS). The secondary outcomes determined morphine consumption and chronic pain evaluation according to the Neuropathic Pain Symptom Inventory (NPSI) after hospital discharge. Results: At rest, the pain intensity was significantly higher in the CON group than in the QLB and TAPB groups at hours two and eight. Upon activity, the pain in the control subjects was more severe than in the QLB and TAPB groups in three and two of five measurements, respectively. Moreover, morphine consumption was significantly lower in the QLB (9 (5–10)) and TAPB (10 (6–14)) groups than in the CON (16 (11–19)) group. Persistent postoperative pain was significantly lower in the QLB group than in the CON group at months one and six following hospital discharge. Conclusions: Both the QLB and TAPB can improve pain management after cesarean delivery. Moreover, the QLB might reduce the severity of persistent postoperative pain months after cesarean section.

Keywords: Neuropathic Pain Symptom Inventory; patient-controlled analgesia; quadratus lumborum block; transversus abdominis plane block; visual analog scale (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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