Abstract: Objective To compare the effects of ultrasound‑guided quadratus lumborum block (QLB) and transversus abdominis plane block (TAPB) in multimodal analgesia on the enhanced recovery after caesarean section. Methods Sixty parturients, single birth and full‑term pregnancy (gestational age>37 weeks), American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ, scheduled for cesarean section were divided into 2 groups according to random number table method (n=30): a QLB group and a TAPB group.Spinal anesthesia was used in both groups. At the end of the surgery, patients in the QLB group received bilateral QLB, while patients in the TAPB group received bilateral TAPB under ultrasound guidance immediately. Both groups were injected with 20 ml of 0.375% ropivacaine in each side respectively. All patients underwent patient controlled intravenous analgesia (PCIA). The resting and exercise Numeric Rating Scale (NRS) scores were recorded at 4, 8, 12, 24 h and 48 h after operation. The time of the first pressing analgesia pump, the effective pressing times of analgesia pump within 24 h after operation, the cumulative consumption of sufentanil, the rate of rescue analgesia, the degree of satisfaction with analgesic effect and the adverse reaction within 24 h after operation were recorded. The first time of anal exhaust, eating common food, sitting up, standing up, getting out of bed after operation and colostrum production were also recorded. Results The resting NRS scores at 24, 48 h and the exercise NRS scores at 8, 12, 24, 48 h after operation were significantly lower in QLB group than those values in TAPB group (P<0.05). The time of the first pressing analgesia pump in QLB group was significantly later than that time in TAPB group. The degree of satisfaction with analgesic effect in QLB group was significantly higher than that in TAPB group. The effective pressing times of analgesia pump and the cumulative consumption of sufentanil within 24 h after operation were significantly lower than those values in TAPB group (P<0.05). Meanwhile, the first time of getting out of bed and the time of first colostrum production after operation were significantly earlier in QLB group than those in TAPB group (P<0.05). There was no significant difference between the two groups in the rate of rescue analgesia, the incidence of adverse reactions related to analgesia within 24 h, the first time of anal exhaust, eating common food, sitting up and standing up (P>0.05). Conclusions QLB as a part of multimodal analgesia after cesarean section has better analgesic effect than TAPB with less consumption of opioids. Further studies are needed to address whether QLB has a greater potential in enhancing postoperative recovery after caesarean section than TAPB.
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