Quadratus Lumborum Block After Cesarean Section: Analgesic Efficacy of Different Concentrations of Local Anesthetics

QLB is an injection of a local anesthetics around the quadratus lumborum muscle. It uses a fascial compartment path to extend the distribution of local anesthetics into the posterior abdominal wall and paravertebral space. This central effect can be of vital importance when managing the visceral pain after caesarean section.Many studies have shown that the inclusion of quadratus lumborum block to a multimodal analgesic regimen would reduce pain scores, opioid consumption, and prolonging time to first rescue analgesic after cesarean delivery.However, the dose and concentration of the local anesthetic used among the studies are varied, and literature search identified no randomized controlled trial which looked at the concentration -response of local anesthetic to optimize the concentration resulting in the best pain relief.It is a perspective randomized controlled trial to compare the analgesic efficacy of 2 different concentrations of Bupivacaine to standardize postoperative analgesic protocol used for QLB after caesarean section.

Inclusion Criteria:Participants who are American Society of Anesthesiologists physical status 1 or 2.Participants who have singleton pregnancy at a gestation of at least 37 weeks.Participant who are scheduled for elective caesarean section under spinal anesthesia.Participants who are consented to be enrolled into the study.Exclusion Criteria:Patients who have contraindications to spinal or regional anesthesia (Coagulopathy or on anticoagulants).Who have Allergy or sensitivity to study medications.Who have anatomical abnormalities or localized infection.Who have history of chronic pain or on regular opioids use.Who are unable to comprehend or unable to use the verbal rating pain scoring system,Failed spinal anesthesia or conversion to general anesthesia after spinal anesthesia.