Comparative Efficacy of Ultrasound-Guided Bilateral Quadratus Lumborum Block vs. Conventional Analgesia in Cesarean Section: A Randomized Controlled Trial

Background and Aim: Ultrasound guiding speeds up peripheral nerve blocks, improves quality, lowers local anaesthetic doses, and reduces complications. This study was done with an aim to compare the post-operative analgesic effect of USG guided bilateral quadratus lumborum block with conventional analgesic technique in elective caesarean section patients by total requirement of post-operative analgesic drugs. Material and Methods: We studied 80 patients who were scheduled for caesarean section. All the Patients were given spinal Anaesthesia. At the end of the surgery, the patients were divided into two groups. QLB group (GROUP A): Patients received USG guided Bilateral Quadratus Lumborum Block with 20 ml of 0.25% Ropivacaine on each side(n=40) and Control Group (GROUP B): Patients who did not receive the QLB block and were given Injection Tramadol on demand for post-operative analgesia as per institutional protocol(n=40). Analgesic efficacy of QLB block in caesarean section was assessed by time to first requirement of rescue analgesic drug (Tramadol), VAS scores, and total dose requirement of Tramadol in 24 hrs. Any adverse effects or complications were also observed. Results: QLB block increases the duration of time to first rescue analgesic drug (Tramadol) with significant difference (P < 0.0001) between QLB group (1068.25±157.331 min) and the CONTROL group (222.75±56.27 min). There is a significant decrease in the VAS score in the postoperative period in the QLB group as compared to the control group. It also reduces the total Analgesic requirement (Tramadol) in the first 24 hours with significant difference between the QLB group (105±45.00 mg) and the CONTROL group (357.5±84.39 mg). Conclusion: USG guided Bilateral Quadratus Lumborum block when compared with a standard spinal anaesthetic is associated with a significant decrease of systemic analgesics demand and is a good choice for postoperative pain management in surgery like caesarean section as a part of multimodal analgesia.