Related Experiment Video
Updated: Aug 27, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Quadratus lumborum block versus transversus abdominis plane block for post Caesarean analgesia: A randomized
Sangeeta Khanna1, G V Krishna Prasad1, Vipin J Sharma1
1Senior Advisor (Anaesthesiology), Military Hospital, Kirkee, India.
Background:
Effective postoperative analgesia after lower segment caesarean section (LSCS) is very important for early ambulation and early breast feeding and has a role to play in decreasing postpartum depression. Quadratus lumborum (QL) block, a fascial plane block, is gaining popularity for pain management in lower abdominal surgeries. The aim of the present study was to compare the ultrasound-guided (USG) transversus abdominis plane (TAP) block and QL block in patients undergoing LSCS under spinal anaesthesia.
Methods:
Double-blinded, randomized, controlled, single-centre study done between Aug 2019 and Oct 2019, randomised 80 patients scheduled for LSCS into two groups, QL (N = 40) and TAP (N = 40), receiving USG TAP or QL block 20 ml of 0.25% bupivacaine with 4 mg dexamethasone bilaterally, postoperatively.
Results:
SSPS 20 was used for the statistical analysis Patients were evaluated for 24-h using visual analogue scale (VAS) for pain scores, time to rescue analgesia and the analgesic dose requirement at regular time intervals. Fifteen percent patients in QL block and 75% in TAP block required rescue analgesia (P < 0.001). Significant differences were observed in pain scores at 10 h postoperatively, VAS in QL=1.18 (0.55), TAP=3.08 (1.66) (P < 0.001). By 24 h postoperatively the difference ceased to be statistically significant. Time to rescue analgesia in QL group was 1353 min (+/-224.07) and TAP group 915 min (+/-391.62) (P < 0.001). Average requirement of rescue analgesia (paracetamol) in QL group was 153.84 mg, TAP group 756.09 mg.
Conclusions:
Patients receiving QL block had prolonged analgesic effects and required less use of rescue analgesia in comparison with TAP group in the first 24 h postoperatively.
Trial Number:
CTRI/2019/07/020475.
Related Concept Videos
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Spinal Anesthesia
Abdominal Regions and Quadrants
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
Local Anesthetics: Differential Sensitivity of Nerve Fibers

