21. EVALUATION THE ANALGESIC EFFECT AFTER CESAREAN SECTION BY BILATERAL QUADRATUS LUMBER BLOCK SINGER SHOT UNDER ULTRASOUND GUIDANCE WITH ROPIVACAINE PLUS DEXAMETHASONE

Tran Van Cuong1, Dang Xuan Huynh1, Tran Thu Thao1, Nguyen Ngoc Tram2
1 Hanoi Obstetrics & Gynecology Hospital
2 Hospital of Post and Telecommunications

Main Article Content

Abstract

Object: Evaluate the analgesic effect after cesarean section by bilateral quadratus lumber block
single shot under ultrasound guidance with ropivacaine plus dexamethasone.
Methods: The study was conducted on 60 women who received spinal anesthesia for elective
cesarean section at Hanoi Obstetrics and Gynecology Hospital and received postoperative pain relief
with a single dose of bilateral quadratus lumber block under ultrasound guidance. Patients were
randomly divided into two groups: Group D received a mixture of 20ml ropivacaine 0.2% + 1ml
dexamethasone (2mg) on each side compared with group R using a mixture of 20ml ropivacaine
0.2% + 1ml 0.9% NaCl on each side.
Results: The study results showed that a single dose of Ropivain - Dexamethasone pain relief
better than using Ropivacaine alone: VAS pain scores at rest and during exercise at 48 hours after
surgery of group D were lower than group R and all less than 4 points; pain relief time of group D
lasted longer than group R statistically significant (1083.8 minutes vs. 610.67 minutes; p<0.05); The
amount of morphine consumed in the first 24 hours of group D was statistically significantly lower
than that of group R (4.47 vs 7.4 mg, p<0.05).
Conclusion: Single dose bilateral quadratus lumber block under ultrasound guidance with
Ropivacain- dexamethasone mixture has better analgesic than Ropivacaine alone.

Article Details

References

[1] Blanco R. 271: Tap block under ultrasound
guidance: the description of a “no pops”
technique. Regional Anesthesia and Pain155
Medicine. 2007;32(5):130-130. doi:10.1016/j.
rapm.2007.06.268.
[2] Colla LL, Uskova A, Ben-David B.
Single-shot Quadratus Lumborum Block for
Postoperative Analgesia After Minimally
Invasive Hip Arthroplasty: A New Alternative to
Continuous Lumbar Plexus Block? Reg Anesth
Pain Med. 2017;42(1):125-126. doi:10.1097/
AAP.0000000000000523.
[3] Zorrilla-Vaca A, Li J. Dexamethasone Injected
Perineurally is More Effective than Administered
Intravenously for Peripheral Nerve Blocks: A
Meta-Analysis of Randomized Controlled Trials.
The Clinical Journal of Pain. 2018;34(3):276.
doi:10.1097/AJP.0000000000000519.
[4] Vieira PA, Pulai I, Tsao GC et al., Dexamethasone
with bupivacaine increases duration of analgesia
in ultrasound-guided interscalene brachial plexus
blockade. European Journal of Anaesthesiology
| EJA. 2010;27(3):285-288. doi:10.1097/
EJA.0b013e3283350c38.
[5] Aga A, Abrar M, Ashebir Z et al., The use
of perineural dexamethasone and transverse
abdominal plane block for postoperative
analgesia in cesarean section operations under
spinal anesthesia: an observational study. BMC
Anesthesiology. 2021;21(1):292. doi:10.1186/
s12871-021-01513-4.
[6] Ammar AS, Mahmoud KM, Effect of
adding dexamethasone to bupivacaine on
transversus abdominis plane block for abdominal
hysterectomy: A prospective randomized
controlled trial. Saudi J Anaesth. 2012;6(3):229-
233. doi:10.4103/1658-354X.101213.