الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 135 |  |  |
| | | from | 135 | | |
Abstract
• It is randomized controlled clinical study that was carried at the labor ward of the Ain-Shams University Maternity Hospital on 64 patients.
• Patients in this study who fulfilled the inclusion criteria: Age (20 – 40). Elective cesarean delivery under general anesthesia. Viable fetus, gestational age ≥ 34 weeks. American society anesthesia (ASA) 2, and the exclusion criteria: Patients with medical disorders (Severe pre-eclampsia, eclampsia and uncontrolled diabetes mellitus. Women who had intra-operative complications. ASA 3 or more and Females have history of allergy to local anesthesia and drugs will be used e.g.: Suxamethonium apnea. planned to had elective cesarean section under general anesthesia and at the end of the operation the patients were divided into 2 groups:
group (A) (N=32): had TAP block.
group (B) (N=32): had TQLB.
• In the beginning after taking personal and menstrual history, performing general, abdominal and vaginal examination and abdominal ultrasound and performing labartory investigation
• All cases received general anesthesia, cesarean section was done by senior resident and Intra operative complication was reported.
• Both blocks were performed by senior anesthesiologist bilaterally with complete aseptic precautions and a total 40 mL of 0.25% Bupivacaine (obtained by mixing 20 mL of 0.5% Bupivacaine with 20 mL of normal saline) were injected for bilateral blocks.
• A linear high frequency ultrasound probe was used for TAP block and a low-frequency convex was used for TQLB.
• Patients were shifted to the post anesthesia care unit (PACU) and monitored over a period of ½ an hour for pain at rest, pain on movement (on flexion of lower limbs while patient is in supine position), nausea, and sedation then were monitored at the word at an interval of 0(at PACU), 2, 4, 6 and 8 hours after surgery.
• 1st and total dose of analgesia were reported.
• The results of this study was that According to Patients’ pain perception (VAS-10) at rest and at movement was statistically lower in QLB group throughout 8-hours postoperatively, need of analgesia was less frequent in TQLB, 1st need of analgesia was delayed in TQLB.
• Conclusion:
The quadratus lumborum block is more effective in reducing analgesics and opioids consumption and demands, hospital stay, and colic pain than transversus abdominis plane blocks after cesarean section. This effect is observed up to 8 hours postoperatively.
• RECOMMENDATIONS
It is recommended that TQLB is more effective in managing the post-operative pain and recommended to be used especially in the patients were under general anesthesia due to its effect from time zero post operatively.