Comparative Study between Three Regional Analgesic Modalities Using Ultrasound Guidance for Postoperative Analgesia after Elective Cesarean Section

Background: Cesarean pain hinders early postoperative functional recovery, whereas obstetric patients require distinct postoperative analgesics. Aim: This study compared the postoperative analgesic efficiency of ultrasound (US)-guided transversus abdominis plane (TAP) block, quadratuslumborum block (QLBs), and erector spaceplane block (ESPB) in elective cesarean section (CS) patients under spinal anesthesia. Methods: A prospective randomized, double-blind work was performed on 120 female participants aged ≥ 21 years undergoing elective CS. Participants were allocated into three groups equally and given 20 ml of bupivacaine 0.25% with epinephrine 1:400,000 per side following deliveries and through one-hour post-closure of the skin, in addition to bilateral TAP, anterior QL, and ESP blocks at T9. Results: First rescue analgesiawas considerably delayedin QLB and ESPB contrasted to TAP. Totalketorolac and morphineintake were considerably decreased in QLB and ESPB than TAP. The three groups had considerably varied patient satisfaction. No patient in the three groups had postoperative nausea and vomiting or local anesthetic systemic toxicity. Group QL and ESP had lower resting VAS than group TAP. VAS at movement was lower in QL and ESP than in TAP. Conclusions: Both US-guided ESPB and QLB offered enhanced postoperative analgesia contrasted to TAP block in female patients who had elective CS.