Abstract

Postoperative analgesia after caesarean section is important because it enables early ambulation. Several case reports have shown that local anaesthetic injection around the quadratus lumborum muscle is effective in providing pain relief after various abdominal operations and in patients with chronic pain. The aim of our trial was to access the analgesic efficacy of transmuscular quadratus lumborum block (TQLB) after caesarean section. Methods: This study was done in 80 women posted for caesarean section who were divided into two groups of 40 each.TQLB was given bilaterally, in group R with 20 ml of 0.375% ropivacaine and in group S with 20 ml saline. Patients were operated under spinal anaesthesia and were examined for pain at different time points postoperatively. Time required for first analgesic demand was our primary endpoint. Secondary endpoints were total rescue analgesia (paracetamol)required in 24 hrs, pain scores, nausea, vomiting, sedation and any other complications. Results:The time required for first analgesic demand was 5.9± 0.8hrs in R group and 2.1± 0.2 hrs in group S which was statistically significant. The total paracetamol consumption in 24 hours was 2.2± 0.4gm in group R and 3.9± 0.7gmin group S, the difference being significant. Conclusion: Transmuscular quadratus lumborum block can produce quality analgesia after caesarean section. TQLB not only improves the visual analogue scale (VAS) score but also decreases the rescue analgesic consumption without any complications.

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