Date of this Version


Document Type

DNP Project




Background: Pain management for cesarean section patients postoperatively mainly involves oral analgesics, especially opioids. Further exploration is needed to discover the copious benefits of the quadratus lumborum (QL) block in obstetrics and create recommendations for its use.

Objectives: The systematic review aimed to assess the most current randomized controlled trials (RCTs) regarding the efficacy of the QL block given for postoperative cesarean section pain management. Additionally, the results will be presented in an education module to Certified Registered Nurse Anesthetists (CRNAs).

Data Sources: Investigators used CINAHL, MedLine, EMBASE, and Pubmed databases to answer the PICO question: In patients undergoing cesarean section (P), does the use of an ultrasound-guided perioperative quadratus lumborum block (I) compared to an ultrasound-guided perioperative transversus abdominus plane block (C) improve postoperative pain management (O)?

Methodology: Ten RCTs were included in this systematic review and incorporated in the education module to CRNAs. All studies found the block group to have superior pain management and less opioid consumption. The six studies that compared the QL and TAP block found the QL block to be superior in both pain management and reducing opioid consumption. The education module containing a pre- and post-test and a voiced-over PowerPoint was presented to a group of CRNAs.

Results: Statistical analysis using SPSS revealed a statistically significant knowledge increase from the pre- to post-test, and increased likelihood of recommending the QL block.

Conclusions: The empirical evidence shows the QL block to provide a longer-lasting reduction in pain and opioid consumption. CRNA providers benefit from an educational module presenting evidence-based information on the newest regional block techniques.