A Randomized Control Trial Comparing Analgesic Benefits of Ultrasound-guided Single vs Continuous Quadratus Lumborum Blocks (QLB)vs Intrathecal Morphine(ITM) for Post Cesarean Section Pain

A Randomized Control Trial Comparing Analgesic Benefits of Ultrasound-guided Single vs Continuous Quadratus Lumborum Blocks vs Intrathecal Morphine for Post Cesarean Section Pain

the purpose of this study is to compare opioid consumption in morphine equivalents between the groups that received postoperative analgesia with intrathecal morphine versus US guided QL blocks versus US guided QL catheters

Inclusion Criteria:

• Elective C section via Pfannenstiel incision
• Living singleton pregnancy
• Gestation week at least 37 weeks
• American Society of Anesthesiologists (ASA) status 1, 2 and 3
• Primary and secondary C sections

Exclusion Criteria:

• Chronic pain
• Opioid tolerant patients
• Allergy to drugs used in the study.
• Cognitive dysfunction
• BMI > 40
• Coagulation disorder
• Local infection
• Inability to tolerate oral medication
• Previous intra-abdominal surgery
• Patients who will receive a combined spinal epidural for their C section
• Local anesthetics injected at any other fascial plane except the QLB plane (for e.g.- local wound infiltration by surgeon)
• Patients who received sedation or general anesthesia during their C section (midazolam, ketamine, fentanyl, propofol, hydromorphone)