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

Int J Environ Res Public Health. 2021 Jun 30;18(13):7034. doi: 10.3390/ijerph18137034.

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: analgesia; cesarean section; pain; quadratus abdominis block; transverse abdominis plane block.

Publication types

  • Meta-Analysis

MeSH terms

  • Abdominal Muscles
  • Analgesics, Opioid
  • Cesarean Section* / adverse effects
  • Child
  • Female
  • Humans
  • Pain, Postoperative / prevention & control
  • Pregnancy
  • Quality of Life*
  • Randomized Controlled Trials as Topic
  • Single-Blind Method

Substances

  • Analgesics, Opioid