Quadratus Lumborum Block Reduced Postpartum Uterine Pain After Normal Spontaneous Delivery: A Prospective, Randomized, Double‐Blind, Controlled Trial

ABSTRACT Background and Aims Normal spontaneous delivery is often accompanied by various types of pain; postpartum uterine pain can persist for 2 or 3 days after childbirth. The quadratus lumborum block (QLB) is a relatively safe, cost‐effective, and efficacious pain management strategy used in various abdominal surgeries. The present study aimed to determine the effectiveness of QLB in relieving postpartum uterine contraction pain in the immediate 48 h postpartum period. Methods Sixty‐six women, who normally and spontaneous delivered between May 2022 and August 2022, were randomly assigned to undergo either QLB with 0.375% ropivacaine or QLB with pure normal saline for postpartum uterine pain relief. Primary outcome was the severity/degree of uterine pain according to the visual analog scale (VAS) score. Pain interference impacting participants' activities of daily living before and 1, 6, 12, 24, 36, and 48 h after intervention was a secondary outcome. Results Those in the ropivacaine group required significantly fewer rescue analgesics and exhibited substantially lower mean VAS pain scores at rest and during activity, and a lower level of pain interference when compared with those in the normal saline group ( p < 0.001) at 1, 6, 12, 24, 36, and 48 h after QLB. Conclusion QLB was a valuable option for managing postpartum uterine pain after normal spontaneous delivery. It offered the benefits of stable hemodynamics, cost‐effectiveness, simplicity, and less pain interference with the activities of daily living, and minimal discomfort during the treatment process, with very few negative side effects. Trial Registration: study registered with the clinical trials registry website (12/05/2022). ClinicalTrials.gov identifier: NCT05371015.