In pregnant women undergoing cesarean section, quadratus lumborum block-3 provided more effective analgesia and patient satisfaction when compared to quadratus lumborum block-2.

A randomized clinical trial compared the postsurgical analgesic impact of an ultrasound-guided quadratus lumborum block-2 (QLB-2) with a quadratus lumborum block-3 (QLB-3) following cesarean delivery under general anesthesia.

Overall, 143 term pregnant females who were scheduled for elective cesarean section under general anesthesia and had American Society of Anesthesiologists II status were divided randomly into QLB-2 and QLB-3 groups. Following surgery under standardized general anesthesia, both groups had QLBs using 0.3 mL.Kg-1 0.25% Bupivacaine. Additional analgesia was administered using patient-controlled analgesia (PCA) devices.

The major endpoints were pain scores at 0, 2, 6, 12, and 24 hours. Patient satisfaction, anesthesia duration, requirements of rescue analgesic, actual Tramadol dosages provided, and the demands for PCA were also noted.

Overall, 104 subjects were statistically assessed. At 2, 6, 12, and 24 hours after surgery, the QLB-3 group's pain scores were statistically reduced. The QLB-3 group exhibited a prolonged anesthesia time. Patients who got QLB-3 block showed dramatically reduced PCA needs and Tramadol use. Additionally, the initial analgesic requirement period was longer, and patient satisfaction was better. Additionally, there were no complications during any of the surgeries, and PCA's side effects were minimal.

Although both QLBs had good safety profiles and reliability, QLB-3 delivered more efficient analgesia and patient satisfaction in cesarean section than QLB-2.