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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

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...

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Autores principales: Borys, Michał, Zamaro, Aleksandra, Horeczy, Beata, Gęszka, Ewa, Janiak, Marek, Węgrzyn, Piotr, Czuczwar, Mirosław, Piwowarczyk, Paweł
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037180/
https://www.ncbi.nlm.nih.gov/pubmed/33800559
http://dx.doi.org/10.3390/ijerph18073500
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author Borys, Michał
Zamaro, Aleksandra
Horeczy, Beata
Gęszka, Ewa
Janiak, Marek
Węgrzyn, Piotr
Czuczwar, Mirosław
Piwowarczyk, Paweł
author_facet Borys, Michał
Zamaro, Aleksandra
Horeczy, Beata
Gęszka, Ewa
Janiak, Marek
Węgrzyn, Piotr
Czuczwar, Mirosław
Piwowarczyk, Paweł
author_sort Borys, Michał
collection PubMed
description 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.
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spelling pubmed-80371802021-04-12 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 Int J Environ Res Public Health Article 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. MDPI 2021-03-28 /pmc/articles/PMC8037180/ /pubmed/33800559 http://dx.doi.org/10.3390/ijerph18073500 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Borys, Michał
Zamaro, Aleksandra
Horeczy, Beata
Gęszka, Ewa
Janiak, Marek
Węgrzyn, Piotr
Czuczwar, Mirosław
Piwowarczyk, Paweł
Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study
title Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study
title_full Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study
title_fullStr Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study
title_full_unstemmed Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study
title_short Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study
title_sort quadratus lumborum and transversus abdominis plane blocks and their impact on acute and chronic pain in patients after cesarean section: a randomized controlled study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037180/
https://www.ncbi.nlm.nih.gov/pubmed/33800559
http://dx.doi.org/10.3390/ijerph18073500
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