Enhancing Post-Cesarean Recovery: A Randomized Trial of pain control strategies.

Haggag, Adham M; Abouseeda, Marwa Maged; Kamel, Walid Y

doi:10.21608/egja.2025.377302.1058

Enhancing Post-Cesarean Recovery: A Randomized Trial of pain control strategies.

Document Type : Original Article

Authors

¹ Department of Anesthesiology, Intensive Care Medicine and Pain Management, Ain Shams University, Cairo, Egypt

² Department of Anesthesiology, Intensive Care Medicine and Pain Management, Benha University, Egypt

10.21608/egja.2025.377302.1058

Abstract

Background:
The Obstetric Quality of Recovery-10, a validated patient-reported outcome, can evaluate recovery patterns following childbirth. The objective of this study was to investigate how two distinct pain control methods influence the recovery quality of expectant mothers undergoing a cesarean delivery with spinal anesthesia.
Methods: A total of 128 parturients undergoing elective cesarean section were randomly assigned into two equal groups. Group (PCA) The patient received 0.5 mg/ml of nalbuphine using patient-controlled analgesia pump and Group (QL). The patients received quadratus lumborum block by injecting 20 ml of 0.25 % bupivacaine on each side. The primary outcome was the total ObsQor-10 score. Secondary outcome was to test psychometric validity of the ObsQoR‑10 score in Egyptian women having elective cesarean section.
Results: The median total score of quality of recovery was significantly better in the QL group compared to the PCA group (82.5 [11-100] vs 86 [34-100], respectively; P = 0.033). The correlation between ObsQoR‑10 and global health NRS was strong, median ObsQoR‑10A score for good recovery was 86 (47–100) compared to poor recovery’s score of 60 (11–76) with P < 0.001. Reliability was excellent: Cronbach’s alpha = 0.958 &average inter-item correlation = 0.716. Test re-test reliability was good with an intra-class correlation coefficient of 0.694 (95% CI 0.636–0.751). Completion rate was 100%.
Conclusion: Compared to nalbuphine PCA, QL block provided superior quality of recovery profiles following cesarean section. The ObsQoR‑10 is a valid and reliable tool to assess postoperative recovery after cesarean section in Egyptian women.

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