The analgesic effect of transmuscular quadratus lumborum block versus erector spinae plane block for women undergoing elective Caesarean section: A randomized controlled trial.

Autor:	Mostafa M; Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt., Nasr MA; Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt., Fawzy M; Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt., Awad AE; Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt., Waheeb MM; Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Jazyk:	angličtina
Zdroj:	British journal of pain [Br J Pain] 2023 Oct; Vol. 17 (5), pp. 438-446. Date of Electronic Publication: 2023 Jun 02.
DOI:	10.1177/20494637231181513
Abstrakt:	Background: We aimed to compare the analgesic effect and quality of recovery of transmuscular quadratus lumborum block (QLB) and erector spinae plane block (ESPB) in the presence of multimodal analgesia following Caesarean section. Methods: This randomised controlled trial included full-term pregnant women who underwent elective Caesarean section under spinal anaesthesia without intrathecal morphine. The included women were randomised to receive either bilateral QLB ( n = 51) or bilateral thoracic ESPB ( n = 51), in addition to the control group ( n = 51) who did not receive any block. All participants received regular paracetamol (1 g/6h) and diclofenac (50 mg/8 h). Intravenous morphine was used as a rescue analgesic. The primary outcome was time to first morphine requirement. Secondary outcomes included total postoperative morphine consumption and total Obstetric Quality of Recovery-11 (ObsQoR-11) score. Results: We analysed 51, 50 and 48 patients in the QLB, ESPB and control groups, respectively. The time to first morphine requirement in both QLB and ESPB groups was longer than that in the control group (median [quartiles] time: 6 [6,12] h, 6 [6,6] h and 4 [3,4] h, respectively; p -value <0.001), without significant differences between the two former groups. The total morphine consumption in both QLB and ESPB groups was lower than that in the control group (median [quartiles]:0 [0,5] mg, 0 [0,5] mg and 25 [25,30] mg, respectively; p -value <0.001), without significant differences between the two former groups. The QLB and ESPB groups had comparable ObsQoR-11 score, and both groups' scores were higher than the control group. Conclusion: In patients undergoing elective Caesarean section under spinal anaesthesia without intrathecal morphine, both QLB and ESPB provided superior analgesia and quality of recovery compared to the standard care, without significant difference between the two blocks. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2023.)
Databáze:	MEDLINE
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