Analgesic Efficacy of Different Nerve Blocks in Postoperative Cesarean Section

Analgesic Efficacy of Erector Spinae Block , Quadratus Lumborum Block and Intrathecal Morphine for Post Operative Pain Relief After Cesarean Section, A Prospective Randomized Single-Blind Controlled Study

Analgesic efficacy of Erector Spinae, Quadratus Lumborum and Intrathecal Morphine for post operative pain relief after cesarean section, A Prospective Randomized Single-Blind Controlled Study.

intrathecal morphine for intrathecal morphine group . bupivacaine 0.25% for Quadratus Lumborum and Erector Spinae nerve block groups .

Intrathecal morphine Group: All members of this group will receive spinal anesthesia with 12 mg 0.5% (2.2ml) hyperbaric bupivicane with intrathecal morphine(100mcg). QLB Group: All members of this group will receive bilateral quadratus lumborum block after spinal anesthesia at end of operation. The QLB will be performed by using bupivacaine 0.25% .ESB Group: All members of this group will receive bilateral erector spinae block after spinal anesthesia at end of operation. The ESB will be performed by using bupivacaine 0.25% (15 ml in each side) .

onset of pain . pain intensity using Numerical Analogue Score ( NRS) . ordered from 0 to 10 . 0 value indicates no pain , 10 value indicates worst pain

Inclusion Criteria: 18-40 years old more or equal 37 weeks of gestation ASA 1,2 Elective cesarean delivery Exclusion Criteria: Patient refusal inability to cooperate with or understand the study local infection. bleeding disorder known anaphylaxis to any drug used in the trial ASA physical status more than 2 emergency operations chronic opioid use (opioid use in the past 3 months) Neurologic deficit or disorder contraindication to regional anesthesia.