• Kalpana Verma, Aman Malawat, Durga Jethava, and Dharam Das Jethava.
• Department of Anaesthesiology, Critical Care and Pain Management, Mahatma Gandhi Medical College and Hospital, RIICO Institutional Area, Sitapura, Jaipur, Rajasthan, India.
• Indian J Anaesth. 2019 Oct 1; 63 (10): 820-826.

Background And AimsEffective post-operative analgesia after caesarean section (CS) is important because it facilitates early amelioration, ambulation and expedites breastfeeding. Quadratus lumborum (QL) block is an interfascial block providing effective visceral and somatic analgesia. We conducted this study to compare the analgesic efficacy of QL block and transversus abdominis plane (TAP) block after CS.MethodsIn this single hospital-based, prospective double-blind study, 60 patients scheduled for an elective CS between December 2018 and January 2019 were randomised to receive ultrasound-guided TAP block (n = 30) or QL block (n = 30) bilaterally with 0.2% ropivacaine postoperatively. The primary objective was to measure the time for rescue analgesic requirement and secondary objectives included the total number of analgesic dose required over a period of 72 hours and severity of post-operative pain assessment via visual analogue scale (VAS) score at rest and with movement. Statistical analysis was done using SPSS version 21. Data were compared using the Chi-square test and students' t-test.ResultsTime for rescue analgesic requirement was higher in the QL group than the TAP group (mean ± SD: 68.77 ± 1.74 h vs. 13.3 ± 1.21 h) (P < 0.001). The QL group had significantly less analgesic demand (P < 0.001) at 2, 4, 6, 12, 24, 36, 48 and 72 h post-CS. The VAS at rest and movement was significantly reduced in the QL group at all times.ConclusionThe QL block provided prolonged and effective analgesia in comparison to TAP block up to 72 hours post-CS.Copyright: © 2019 Indian Journal of Anaesthesia.

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