Quadratus lumborum Block

Abstract

Introduction: The majority of women having planned cesarean section receive spinal anesthesia for the procedure. Typically, spinal opioids are administered during the same time as a component of multimodal analgesia to provide pain relief in the 16 – 24 hours period postoperatively. The ultrasound- guided quadratus lumborum block is emerged as a new regional analgesic technique that blocks T5 – L1 nerve branches and has an evolving role in postoperative analgesia for lower abdominal surgeries and may be a potential alternative to spinal opioids. If found effective, it will give the advantage of a reduction in opioid associated adverse effects while providing similar quality of analgesia.

Methods: We performed bilateral ultrasound- guided quadratus lumborum block in 50 women who received a spinal anesthetic for an elective cesarean delivery and evaluated their NRS, post-operative opioids consumption and patient satisfaction the first 24 hours after the block.

Results: In all 50 patients, there was no additional opioids consumption during the first 24 h after the block. Numeric Rating Scale (NRS) for pain was less than 4 in the first 24 hours. Women were all very satisfied with the quality of pain relief.

Discussion: Ultrasound- guided quadratus lumborum block may be a promising anesthetic adjuvant for post-cesarean analgesia. Further randomized controlled trials are needed to compare the efficacy of the ultrasound- guided quadratus lumborum block with intrathecal opioids.

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