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Compare the type III and type II quadratus lumborum block (QLB) to transversus abdominis plane block (TAPB) regarding efficacy in CS
The transversus abdominis plane block (TAPB) is administered between the internal oblique muscle and the transversus abdominis muscle in the fascial plane, directly pointing to the somatic nerves T6-L1 that run in this plane. In addition, meta-analyses demonstrate that it is an effective analgesic for somatic pain and diminishes opiate intake. It has been reported that TAPB is an efficient analgesic approach following cesarean section .
The quadratus lumborum (QL) muscle block (QLB) is a fascial plane block as local anesthetic (LA) is introduced nearby to the QL muscle to numb the thoracolumbar nerves. QLB is categorized into four types according to drug administration location, I (lateral), II (posterior), III (anterior/transmuscular), and Intravenous, (intramuscular). QLB can effectively decrease both visceral and somatic pain by LA distribution to the thoracic paravertebral space (TPVS), as this block ensures effective pain control from the T7 to L1 dermatomes. QLB is one of the regional techniques that provides the greatest benefit in post-CS pain control, as it is progressively applied in obstetric anesthetic precise to improve analgesic results.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Quadratus lumborum block type II | Active Comparator | A 22 gauge needle was positioned between the erector spinae muscle in the thoracolumbar fascia's middle layer |
|
| Quadratus lumborum block type III | Active Comparator | A 22 gauge needle was positioned between the psoas and quadratus lumborum muscles at the anterior fascia lumbosacral |
|
| Transversus abdominis plane block | Active Comparator | A 22 gauge needle was positioned between the internal oblique and transversus abdominis muscles |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quadratus lumborum block typen II | Procedure | A 22 gauge needle was positioned between the quadratus lumborum muscle posterior border and the erector spinae muscle in the thoracolumbar fascia's middle layer |
| Measure | Description | Time Frame |
|---|---|---|
| Total postoperative consumed pethidine | Numerical rating scales (NRS) score was evaluated at Post Anesthesia Care Unit (PACU), 2, 4, 6, 8, 12, 18, and 24 hours as as 0 is no pain and 10 is the worst pain imaginable. If the NRS score remained ≥ 4, we provided a bolus pethidine (0.5 mg/kg intravenous) and repeatable after 30 minutes if NRS remains≥ 4. | 24 hour postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Time of the first analgesic request | If the Numerical rating scales (NRS) score remained ≥ 4, we provided a bolus pethidine (0.5 mg/kg intravenous). | 24 hour postoperatively |
| Patient satisfaction |
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Inclusion Criteria:
Exclusion Criteria:
Females
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The General Authority for Teaching Hospitals and Institutes | Cairo | 11511 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
after the end of study for one year
The data will be available upon a reasonable request from the corresponding author
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| Quadratus lumborum block III | Procedure | A 22 gauge needle was positioned between the psoas and quadratus lumborum muscles at the anterior fascia lumbosacral |
|
| Transversus abdominis plane block | Procedure | A 22 gauge needle was positioned between the internal oblique and transversus abdominis muscles |
|
The level of patient satisfaction was graded on a 5-point Likert scale as 0= extremely dissatisfied, 1= dissatisfied, 2= neither satisfied nor dissatisfied, 3= satisfied, 4= extremely satisfied
| 24 hour postoperatively |
| The degree of postoperative pain | Numerical rating scales (NRS ) score was evaluated at Post Anesthesia Care Unit (PACU), 2, 4, 6, 8, 12, 18, and 24 hours as as 0 is no pain and 10 is the worst pain imaginable. | 24 hour postoperatively |