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Vol 89, No 2 (2018)
Research paper
Published online: 2018-02-28
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Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

Marcin Mieszko Mieszkowski12, Ewa Mayzner-Zawadzka2, Bułat Tuyakov13, Marta Mieszkowska4, Maciej Żukowski5, Tomasz Waśniewski6, Dariusz Onichimowski12
DOI: 10.5603/GP.a2018.0015
·
Pubmed: 29512813
·
Ginekol Pol 2018;89(2):89-96.
Affiliations
  1. The Clinical Department of Anesthesiology and Intensive Care, Voivodal Specialistic Hospital, Olsztyn, Poland
  2. Department of Anesthesiology and Intensive Care, Collegium Medicum, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
  3. Department of Surgery, Faculty of Medical Sciences,, University of Warmia and Mazury, Olsztyn, Poland
  4. Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Warmia and Mazury, Olsztyn, Poland
  5. The Clinical Department of Gynecology and Obstetrics, Municipal Polyclinical Hospital, Olsztyn, Poland
  6. Department of Gynecology and Obstetrics, Collegium Medicum, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland

open access

Vol 89, No 2 (2018)
ORIGINAL PAPERS Obstetrics
Published online: 2018-02-28

Abstract

Objectives: Quadratus Lumborum Block in contrast to Transversus Abdominis Plane Block contains a unique component which not only stops somatic pain but also inhibits visceral pain by spreading the local anesthetic to the paravertebral space. This study was designed to determine whether performing the Quadratus Lumborum Block type I in patients un­dergoing cesarean section would be associated with both decreased morphine consumption and decreased pain levels in the postoperative 48-hour period.

Material and methods: Sixty patients undergoing caesarean section under spinal anesthesia were randomly and equally assigned to one or other of two groups: QLB I (who received Bilateral Quadratus Lumborum Block type I with the use of 24 mL 0.375% ropivacaine per side) or a Control group. In both groups, on-demand morphine analgesia was administered postoperatively within the first 48 hours. The following were measured: the morphine consumption; the time elapsed from the C-section until the first dose of morphine; and the levels of pain intensity among patients in rest (numeral pain rating scale).

Results: There were no statistically significant demographic data differences between the QLB I and Control groups. The following significant differences were observed in the 48-hour postoperative period: morphine consumption was higher in the Control group (p = 0.000); the time elapsed from the C-section until the first dose of morphine was longer in QLB I group (p < 0.05); and the median of the pain numeric rating scale was higher in the Control group (p < 0.05).

Conclusions: Quadratus Lumborum Block type I significantly reduces morphine consumption and pain levels up to 48 hours postoperatively.

Abstract

Objectives: Quadratus Lumborum Block in contrast to Transversus Abdominis Plane Block contains a unique component which not only stops somatic pain but also inhibits visceral pain by spreading the local anesthetic to the paravertebral space. This study was designed to determine whether performing the Quadratus Lumborum Block type I in patients un­dergoing cesarean section would be associated with both decreased morphine consumption and decreased pain levels in the postoperative 48-hour period.

Material and methods: Sixty patients undergoing caesarean section under spinal anesthesia were randomly and equally assigned to one or other of two groups: QLB I (who received Bilateral Quadratus Lumborum Block type I with the use of 24 mL 0.375% ropivacaine per side) or a Control group. In both groups, on-demand morphine analgesia was administered postoperatively within the first 48 hours. The following were measured: the morphine consumption; the time elapsed from the C-section until the first dose of morphine; and the levels of pain intensity among patients in rest (numeral pain rating scale).

Results: There were no statistically significant demographic data differences between the QLB I and Control groups. The following significant differences were observed in the 48-hour postoperative period: morphine consumption was higher in the Control group (p = 0.000); the time elapsed from the C-section until the first dose of morphine was longer in QLB I group (p < 0.05); and the median of the pain numeric rating scale was higher in the Control group (p < 0.05).

Conclusions: Quadratus Lumborum Block type I significantly reduces morphine consumption and pain levels up to 48 hours postoperatively.

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Keywords

quadratus lumborum block type I, ropivacaine, cesarean section, multimodal analgesia

About this article
Title

Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

Journal

Ginekologia Polska

Issue

Vol 89, No 2 (2018)

Article type

Research paper

Pages

89-96

Published online

2018-02-28

Page views

4911

Article views/downloads

3629

DOI

10.5603/GP.a2018.0015

Pubmed

29512813

Bibliographic record

Ginekol Pol 2018;89(2):89-96.

Keywords

quadratus lumborum block type I
ropivacaine
cesarean section
multimodal analgesia

Authors

Marcin Mieszko Mieszkowski
Ewa Mayzner-Zawadzka
Bułat Tuyakov
Marta Mieszkowska
Maciej Żukowski
Tomasz Waśniewski
Dariusz Onichimowski

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