Comparison of the analgesic efficiency of ultrasound guided transversalis fascia plane block and anterior quadratus lumborum block in cesarean delivery: A randomised study
Sezgin Bilgin, Hakan Aygün, Caner Genç, Burhan Dost, Serkan Tulgar, Ersin Köksal
Samsun Eğitim ve Araştırma Hastanesi
Giriş: Quadratus lumborum blocks (QLB) and transversalis fascia plane block (TFPB) are relatively novel regional anesthesia techniques, and the efficacy for postoperative analgesia in cesarean delivery (CD) has been demonstrated in separate studies. The aim of the present study is to compare the analgesic efficacy of the anterior QLB and TFPB performed at the end of surgery in patients undergoing spinal anesthesia for CD.
Gereç ve Yöntem: After the ethical committee approval (2021/379) this randomized, controlled, assessor blinded study was conducted between June 18 and October 1, 2022. Inclusion criteries were being pregnant for at least 37 weeks, planning an elective cesarean operation for patients between the ages of 18-45. The study was registered to clinical trial (NCT05408403). Ultrasound guided Anterior-QLB was performed to 25 patients and TFPB was performed to 24 patients, postoperatively. Multimodal analgesia was applied to all patients, routinely. Morphine consumption, first opioid requirement time, and Numeric Rating Scale (NRS) scores were measured.
Bulgular: There was no significant difference between the groups in terms of age and body mass index. Cumulative morphine consumptions were similar at 3th, 6th and 9th hours (p>0.05), however, it was lower at the 12th, 18th and 24th hours in the QLB group when compared to the TFPB group (p = 0.011, p = 0.002 and p = 0.002, respectively). Time to first opioid requirement was similar between the groups (p = 0,631). There was no significant difference between the groups in terms of NRS scores, except for the first hour postoperatively. NRS scores were significantly lower in the TFPB group in the postoperative 1st hour (p<0.05).
Tartışma ve Sonuç: In patients undergoing cesarean section, TFPB and anterior QLB have similar analgesic efficacy . The groups were similar in terms of NRS scores and analgesia requirement in the first 9 hours, when postoperative pain relief is most important.
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