Analgesic efficacy of a quadratus lumborum block and ilioinguinal-iliohypogastric block in cesarean deliveries: a randomized study.

Abstract

Background: Quadratus lumborum block (QLB) and ilioinguinal-iliohypogastric nerve (II-IH) blocks are used as components of multimodal analgesia for postoperative pain relief following cesarean delivery. The aim of this prospective, randomized study was to compare the efficacy of a quadratus lumborum block and ilioinguinal-iliohypogastric block applied to patients who underwent cesarean delivery under spinal anesthesia on total opioid analgesic consumption and Numerical Rating Scale (NRS) scores within the first 24 hours postoperatively.

Methods: Seventy pregnant women who underwent cesarean delivery under spinal anesthesia were analyzed. The women were randomized into the QLB group (N.=34) and the II-IH group (N.=36). Postoperatively, bilateral anterior quadratus lumborum block was applied to the QLB group and bilateral ilioinguinal-iliohypogastric block was applied to the II-IH group. Tramadol consumption, NRS scores, and drug side effects were recorded at 2, 4, 8, 12, and 24 hours postoperatively.

Results: Total tramadol consumption within the first 24-hours was significantly lower in the QLB Group than in the II-IH Grup (41.2±65.7 vs. 94.4±95.5mg, respectively; P=0.013). The NRS Score was low in both groups, but there was no significant difference between the groups. We found that 67.6% of patients in the QLB group and 41.7% of patients in the II-IH group did not require rescue analgesia within the first 24 hours (P=0.029).

Conclusions: Quadratus lumborum block and ilioinguinal-iliohypogastric blocks applied for postoperative analgesia after cesarean delivery are associated with a low NRS Score in the first 24 hours. Quadratus lumborum block is associated with lower opioid consumption than an ilioinguinal-iliohypogastric block, suggesting that a quadratus lumborum block is preferable in cesarean delivery.