A triple-blinded randomized trial comparing spinal morphine with posterior quadratus lumborum block after cesarean section.
Int J Obstet Anesth
; 40: 32-38, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31353177
ABSTRACT
BACKGROUND:
This study aimed to compare the postoperative analgesic effects of ultrasound-guided posterior quadratus lumborum block with spinal morphine, after cesarean section, using the visual analogue scale pain score.METHODS:
One-hundred-and-seventy-six pregnant women scheduled for elective cesarean section with spinal anesthesia were randomly allocated into four groups to receive spinal morphine 0.1â¯mg (group M+); spinal saline (M-); posterior quadratus lumborum block using either 0.3% ropivacaine (0.45â¯mL/kg each side, maximum 150â¯mg) group pQ+); or saline (pQ-). All patients received 11-13â¯mg hyperbaric bupivacaine 0.5% and 10⯵g fentanyl. Intravenous droperidol, fentanyl and acetaminophen were administered during surgery. Bilateral posterior quadratus lumborum block was performed immediately after surgery. Postoperative pain was assessed at 0.5, 1, 2, 4, 6, 18 and 24â¯h after surgery, and the pain score 6â¯h after surgery was the primary endpoint.RESULTS:
One-hundred-and-forty-six patients were included in the final analysis. Pain scores 6â¯h after surgery, both at rest and when moving, were significantly different when comparing the M+pQ+ group with the M-pQ+ or M-pQ- groups, and when comparing the M+pQ- group with the M- pQ+ or M- pQ- groups (all Pâ¯<0.05). There was no significant difference between the M+pQ+ and M+pQ- groups, or between the M-pQ+ and M-pQ- groups.CONCLUSION:
Spinal morphine improved postoperative analgesia but the combination of posterior quadratus lumborum block with spinal morphine did not lead to further improvement.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dor Pós-Operatória
/
Cesárea
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Analgesia Obstétrica
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Raquianestesia
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Morfina
/
Bloqueio Nervoso
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Int J Obstet Anesth
Ano de publicação:
2019
Tipo de documento:
Article