Comparing the effectiveness of ultrasound guided transverse abdominis plane block and quadratus lumborum block for post operative pain management in lower segment caesarean section patients– A randomised controlled trial

Background and Aims: Effective postoperative analgesia following cesarean section is crucial, as pain not only causes physical suffering but can also impede early ambulation, breastfeeding, and bonding, potentially increasing the risk of postpartum depression. This randomized controlled trial aimed to compare the analgesic efficacy of the Ultrasound-guided Transversus Abdominis Plane (TAP) block with the Quadratus Lumborum (QL) block in patients undergoing lower segment cesarean section under spinal anesthesia. The primary objectives were to compare pain scores at rest and on movement, and the requirement for rescue analgesiaMaterials and Methods: This randomised controlled trial study was conducted among 76 patients posted for caesarean section. Using ultrasound, 38 patients received TAP block (Group T) and 38 patients received QL block (Group Q) post caesarean section. Sensory score, VAS score and rescue analgesic requirements were compared between the two groups.Results: There was significant difference in sensory score between the groups at 4, 6 and 12 hours (p value < 0.001). In Group Q, all 38 patients had sensory score 2 at 4 hours and 6 hours, whereas Group T had sensory score 1 (97.4% vs 18.4%, p value < 0.001) at 4 hours and 6 hours respectively. Group Q had lower VAS score at rest from 1 to 36 hours than group T (p value< 0.001). Significant difference was seen between the groups at 1, 2, 4, 6, 24, 36 hours (p value < 0.001). The dynamic VAS score at 24 hours was 4.58+1.177 in group T vs 3.41+0.802 in group Q (p value