Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study

Borys, Michał; Zamaro, Aleksandra; Horeczy, Beata; Gęszka, Ewa; Janiak, Marek; Węgrzyn, Piotr; Czuczwar, Mirosław; Piwowarczyk, Paweł

doi:10.3390/ijerph18073500

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Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study

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Second Department of Anesthesia and Intensive Care, Medical University of Lublin, 20-059 Lublin, Poland

Department of Obstetrics and Perinatology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warszawa, Poland

Anesthesiology and Intensive Care Department with the Center for Acute Poisoning, St. Jadwiga Provincial Clinical Hospital, 35-301 Rzeszów, Poland

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First Department of Anesthesiology and Intensive Care, Medical University of Warsaw, 02-091 Warszawa, Poland

Author to whom correspondence should be addressed.

Academic Editor: Paul B. Tchounwou

Int. J. Environ. Res. Public Health 2021, 18(7), 3500; https://doi.org/10.3390/ijerph18073500

Received: 23 February 2021 / Revised: 22 March 2021 / Accepted: 24 March 2021 / Published: 28 March 2021

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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Abstract

Background: Severe postoperative pain is a significant problem after cesarean sections. Methods: This study was a randomized, controlled trial of 105 patients conducted in two hospitals. All patients were anesthetized spinally for elective cesarean section. Each participant was randomly allocated to one of three study groups: the quadratus lumborum block (QLB) group, the transversus abdominis plane block (TAPB) group, or the control (CON) group. The primary outcome of this study determined acute pain intensity on the visual analog scale (VAS). The secondary outcomes determined morphine consumption and chronic pain evaluation according to the Neuropathic Pain Symptom Inventory (NPSI) after hospital discharge. Results: At rest, the pain intensity was significantly higher in the CON group than in the QLB and TAPB groups at hours two and eight. Upon activity, the pain in the control subjects was more severe than in the QLB and TAPB groups in three and two of five measurements, respectively. Moreover, morphine consumption was significantly lower in the QLB (9 (5–10)) and TAPB (10 (6–14)) groups than in the CON (16 (11–19)) group. Persistent postoperative pain was significantly lower in the QLB group than in the CON group at months one and six following hospital discharge. Conclusions: Both the QLB and TAPB can improve pain management after cesarean delivery. Moreover, the QLB might reduce the severity of persistent postoperative pain months after cesarean section. View Full-Text

Keywords: Neuropathic Pain Symptom Inventory; patient-controlled analgesia; quadratus lumborum block; transversus abdominis plane block; visual analog scale

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Borys, M.; Zamaro, A.; Horeczy, B.; Gęszka, E.; Janiak, M.; Węgrzyn, P.; Czuczwar, M.; Piwowarczyk, P. Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study. Int. J. Environ. Res. Public Health 2021, 18, 3500. https://doi.org/10.3390/ijerph18073500

AMA Style

Borys M, Zamaro A, Horeczy B, Gęszka E, Janiak M, Węgrzyn P, Czuczwar M, Piwowarczyk P. Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study. International Journal of Environmental Research and Public Health. 2021; 18(7):3500. https://doi.org/10.3390/ijerph18073500

Chicago/Turabian Style

Borys, Michał, Aleksandra Zamaro, Beata Horeczy, Ewa Gęszka, Marek Janiak, Piotr Węgrzyn, Mirosław Czuczwar, and Paweł Piwowarczyk. 2021. "Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study" International Journal of Environmental Research and Public Health 18, no. 7: 3500. https://doi.org/10.3390/ijerph18073500

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Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study

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