Randomized Clinical Trial Comparing Quadratus Lumborum Block and Intrathecal Morphine for Postcesarean Analgesia

Abstract

Objective To compare the efficacy of quadratus lumborum (QL) block and intrathecal morphine (M) for postcesarean delivery analgesia. Methods Thirty-one pregnant women with ≥ 37 weeks of gestation submitted to elective cesarean section were included in the study. They were randomly allocated to either the QL group (12.5 mg 0.5% bupivacaine for spinal anesthesia and 0.3 ml/kg 0.2% bupivacaine for QL block) or the M group (12.5 mg bupivacaine 0.5% and 100 mcg of morphine in spinal anesthesia). The visual analog scale of pain, consumption of morphine and tramadol for pain relief in 48 hours, and side effects were recorded. Results Median pain score and/or pain variation were higher in the morphine group than in the QL group (p = 0.02). There was no significant difference in the consumption of morphine or tramadol between groups over time. Side effects such as pruritus, nausea, and vomiting were observed only in the morphine group. Conclusion Quadratus lumborum block and intrathecal morphine are effective for analgesia after cesarean section. Patients undergoing QL block had lower postoperative pain scores without the undesirable side effects of opioids such as nausea, vomiting, and pruritus.

Efficacy of quadratus lumborum block in the treatment of acute and chronic pain after cesarean section: A systematic review and meta-analysis based on randomized controlled trials

“…Rafael. B et al [25] 2016 [26] 2018 Poland Spinal anesthesia 28 29.15 ± 4.5 0.375% ropivacaine on each side 30 28.74 + 3.25 0.9% normal saline ①② Karoline.et al [27] 2022 Brazil Spinal anesthesia 15 33.5 ± 6.7 0.2% bupivacaine on each side 16 31.1 ± 6.4…”