Clinical Report: Evaluation of Ultrasound-Guided Quadratus Lumborum Block

Overview

This systematic review and meta-analysis evaluated the efficacy of the quadratus lumborum block (QLB) for post-cesarean section pain relief, finding it associated with modest reductions in opioid consumption and dynamic pain scores. However, high heterogeneity among studies limits the certainty of these findings.

Background

Post-cesarean section pain management is crucial for improving maternal outcomes and satisfaction. Enhanced Recovery after Surgery (ERAS) protocols emphasize multimodal, opioid-sparing analgesia to mitigate adverse effects associated with opioids. The quadratus lumborum block (QLB) has emerged as a potential alternative for effective pain relief.

Data Highlights

Key Findings

• QLB reduced 24-h morphine consumption significantly (MD = -3.19).
• QLB also reduced 48-h morphine consumption (MD = -16.51).
• 24-h dynamic pain scores were lower with QLB (MD = -0.52).
• No significant differences were found in resting pain, recovery metrics, or satisfaction.
• Opioid-related adverse events were similar between QLB and other techniques.
• The certainty of evidence for the primary outcome was assessed as moderate.

Clinical Implications

QLB may be considered as part of multimodal analgesia protocols for selected patients undergoing cesarean delivery, particularly those not receiving intrathecal morphine.

Conclusion

QLB offers modest benefits in reducing postoperative opioid consumption and dynamic pain after cesarean delivery.

Related Resources & Content

1. Frontiers in Pediatrics, 2026 -- Effects of multimodal analgesia with combined quadratus lumborum block on enhanced recovery after Kasai portoenterostomy in infants with biliary atresia: a retrospective cohort study
2. Surgical Endoscopy, 2026 -- Preperitoneal analgesia under direct visualization: laparoscopic-guided deep rectus sheath block improves postoperative pain control after laparoscopic cholecystectomy: a randomized controlled trial
3. Journal of Gastrointestinal Surgery, 2022 -- Impact of Ultrasound-Guided Transversus Abdominis Plane Block in Combination with Patient-Controlled Intravenous Analgesia on Postoperative Pain Management Following Laparoscopic Cholecystectomy: A Double-Blind, Randomized Trial
4. Anaesthesia, 2026 -- Pain management after elective caesarean section under neuraxial anaesthesia: an updated systematic review and procedure‐specific postoperative pain management (PROSPECT) recommendations
5. PubMed, 2026 -- Posterior quadratus lumborum block versus intrathecal morphine analgesia after scheduled cesarean section: a prospective, randomized, controlled study
6. Response to the editorial on "Comparative analysis of two-stage laparoscopic transversus abdominis plane block versus thoracic epidural anesthesia in bowel resection—an exploratory cohort investigation
7. PROSPECT recommendations for elective cesarean section
8. Posterior quadratus lumborum block versus intrathecal morphine analgesia after scheduled cesarean section: a prospective, randomized, controlled study - PubMed
9. The analgesic effects of novel fascial plane blocks compared with intrathecal morphine after Caesarean delivery: a systematic review and meta-analysis - ScienceDirect