Comparison of Intrathecal Morphine With the Quadratus Lumborum Type 2 Block for Post-operative Analgesia Following Elective Caesarean Section (QLBvITM Study)
Comparison of Intrathecal Morphine With the Quadratus Lumborum Type 2 Block for Post-operative Analgesia Following Elective Caesarean Section (QLBvITM Study)
The investigators are comparing post operative analgesia provided for caesarean section
 patients, with the quadratus lumborum type 2 block and intrathecal morphine.
In Australia the rate of birth via caesarean section (CS) has significantly increased over
 the last twenty years. Improvements in the care of women undergoing CS are important locally,
 nationally and internationally. Compared to women birthing vaginally, women undergoing CS
 experience more adverse events and more pain. Effective pain relief following CS is important
 as it enables early ambulation, encourages maternal bonding, and promotes breastfeeding
 initiation and establishment. Traditional analgesic techniques following CS include opioid
 medications. Whist effective, the use of opioids are associated with frequent and significant
 side effects. Alternative analgesic agents are being explored in an attempt to improve the
 effectiveness of pain relief available to women and clinicians.

 The quadratus lumborum block (QLB) block is an innovative regional analgesic technique. Its
 role as an effective analgesic agent in abdominal surgery is increasing. However, it has not
 been studied for pain relief in Australia after cesarean section.

 In this study, the investigator aims to compare post-operative analgesia and side effects
 between the QLB blocks versus adding morphine the participant's spinal anaesthetic (ITM)
 during the elective C/S. Results from this study will provide information on the analgesic
 impact of this new and emerging therapy and assist in the development of a larger clinical
 trial.
Inclusion Criteria:

 -  Anaesthetist trained in QLB and ITM techniques available

 -  American Society of Anaesthesiologists PS category client I or II

 -  18 years of age or older

 -  Ability to read and understand English

 -  Uncomplicated pregnancy at term (>37 weeks completed gestation)

 -  Booked elective CS

 Exclusion Criteria:

 -  Contraindications to spinal anaesthesia

 -  History of chronic opioid consumption / chronic pain conditions

 -  Known allergy to study drugs

 -  Weight more than 95kg or body mass index (BMI) more than 35 pre operative

 -  Placenta Previa / accreta

 -  Obstructive Sleep apnoea

 -  Severe asthma unable to tolerate Non steroidal anti inflammatory agents