Ultrasound guided Quadratus Lumborum block for analgesia after cesarean delivery: case series

AbstractIntroductionThe majority of women having planned cesarean section receive spinal anesthesia for the procedure. Typically, spinal opioids are administered during the same time as a component of multimodal analgesia to provide pain relief in the 16–24h period postoperatively. The Quadratus Lumborum block is a regional analgesic technique that blocks T5-L1 nerve branches and has an evolving role in postoperative analgesia for lower abdominal surgeries and may be a potential alternative to spinal opioids. If found effective, it will have the advantage of a reduction in opioid associated adverse effects while providing similar quality of analgesia.MethodsWe performed bilateral Quadratus Lumborum block in 3 women who received a spinal anesthetic for a cesarean delivery and evaluated their post-operative opioid consumption and patient satisfaction.ResultsIn all 3 patients, there was no additional opioid consumption during the first 24h after the block. Numeric Rating Scale (NRS) for pain was less than 6 for the first 24h. Women were all very satisfied with the quality of pain relief.DiscussionQuadratus Lumborum block may be a promising anesthetic adjuvant for post-cesarean analgesia. Further randomized controlled trials are needed to compare the efficacy of the Quadratus Lumborum block with intrathecal opioids