Quadratus Lumborum Block Reduced Postpartum Uterine Pain After Normal Spontaneous Delivery: A Prospective,...

Normal spontaneous delivery is often accompanied by various types of pain; postpartum uterine pain can persist for 2 or 3 days after childbirth. The quadratus lumborum block (QLB) is a relatively safe, cost-effective, and efficacious pain management strategy used in various abdominal surgeries. The present study aimed to determine the effectiveness of QLB in relieving postpartum uterine contraction pain in the immediate 48 h postpartum period.

Sixty-six women, who normally and spontaneous delivered between May 2022 and August 2022, were randomly assigned to undergo either QLB with 0.375% ropivacaine or QLB with pure normal saline for postpartum uterine pain relief. Primary outcome was the severity/degree of uterine pain according to the visual analog scale (VAS) score. Pain interference impacting participants' activities of daily living before and 1, 6, 12, 24, 36, and 48 h after intervention was a secondary outcome.

Those in the ropivacaine group required significantly fewer rescue analgesics and exhibited substantially lower mean VAS pain scores at rest and during activity, and a lower level of pain interference when compared with those in the normal saline group (p < 0.001) at 1, 6, 12, 24, 36, and 48 h after QLB.

QLB was a valuable option for managing postpartum uterine pain after normal spontaneous delivery. It offered the benefits of stable hemodynamics, cost-effectiveness, simplicity, and less pain interference with the activities of daily living, and minimal discomfort during the treatment process, with very few negative side effects. Trial Registration: study registered with the clinical trials registry website (12/05/2022). ClinicalTrials.gov identifier: NCT05371015.