Comparison of intrathecal morphine, lateral quadratus lumborum block, and their combination for analgesia and quality of recovery after Caesarean delivery: a randomised, double-blind, two-centre clinical trial.
Br J AnaesthJul 10, 2026 (epub)
Vishal Uppal, Valerie Zaphiratos, Victoria M Allen et al.
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In 30 seconds
This randomized, double-blind, multicenter trial compared the analgesic effects and quality of recovery after Caesarean delivery among women receiving lateral quadratus lumborum block (QLB), intrathecal morphine (ITM), or a combination of both. The study found that QLB significantly reduced resting pain at 6 hours compared to ITM alone, with a mean difference of 2.9 (95% CI 1.3, 4.5; P<0.001).
Key findings
- QLB reduced resting pain at 6 hours compared to ITM (mean difference 2.9; P<0.001).
- ITM+QLB reduced resting pain at 6 hours compared to ITM alone (mean difference 3.3; P<0.001).
- ITM+QLB also reduced coughing pain at 6 hours (mean difference 3.0; P<0.001) and worst pain at 24 hours (mean difference 1.8; P=0.006).
- Pruritus was more frequent with QLB and ITM+QLB compared to ITM alone, but mostly mild.
Why it matters
Effective pain management after Caesarean delivery is crucial for recovery. This study suggests that QLB may provide better early analgesia compared to ITM alone, potentially improving patient outcomes.