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To determine the safety and efficacy of epinephrine plus ropivacaine for bilateral posterior Quadratus Lumborum Block (pQLB) compared with bilateral pQLB using ropivacaine alone in Cesarean Section (CS).
This prospective
trial found the use of epinephrine along with ropivacaine in
pregnant women to effectively increase the safety of the posterior Quadratus
Lumborum Block and offer postoperative pain relief after Cesarean Section. It
also prolongs the duration of anesthesia of this block.
To determine the
safety and efficacy of epinephrine plus ropivacaine for bilateral posterior
Quadratus Lumborum Block (pQLB) compared with bilateral pQLB using ropivacaine
alone in Cesarean Section (CS).
Fifty-two pregnant women were designated to
either of the two groups:
The efficacy and safety of use of epinephrine
as an adjunct therapy to ropivacaine for pQLB were assessed.
The total mean morphine use statistically lower during the first 24 post-operative hours in the e-pQLB group compared to p-QLB group (5.08 ± 3.12, versus 9.11 ± 4.67 SD mg). The patients in the pQLB group had a statistically lower score of Numeric Rating Scale (NRS) values at 6 hours from block, at rest and with movement:
Table 1: NRS scores in e-pQLB group and p-QLB group
Also, a longer time
between block and the first opioid request was observed in e-pQLB group (5.92±2.48
SD hrs) versus p-QLB group (3.78±2.68 SD hrs).
The venous
concentrations of ropivacaine were considerably lower at any time of samples
though at 2 hours in e-pQLB group than p-QLB group.
Use of epinephrine as
an adjunct therapy to ropivacaine was increased the efficacy and length of
pQLB. Furthermore, the block safety was increased, with decreased peak and mean
venous concentration of ropivacaine.
Minerva Anestesiologica
Comparison of ropivacaine plasma concentration after posterior Quadratus Lumborum Block in Cesarean Section with ropivacaine with epinephrine vs plane
Bruno A Zanfini et al.
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