Quadratus lumborum block reduces 24-h morphine consumption by 3.19 mg in cesarean section patientsQuadratus lumborum block reduces morphine use after C section

Acute post-cesarean section (C/S) pain causes adverse maternal outcomes, and multimodal opioid-sparing analgesia is central to Enhanced Recovery after Surgery (ERAS) protocols. Quadratus lumborum block (QLB) is a promising regional technique, but evidence comparing it with other regional blocks remains fragmented. We conducted a systematic review and meta-analysis of RCTs (PubMed, EMBASE, Web of Science; inception to September 2025). Eligible studies included adults undergoing C/S with QLB. Primary outcome was 24-h cumulative morphine consumption; secondary outcomes included pain scores, recovery metrics, and adverse events. RoB 2 and GRADE assessed study quality and evidence certainty. Twenty-three RCTs (1,935 patients) were included. QLB reduced 24-h (MD = −3.19; 95% CI, −5.09, −1.30; p = 0.0009) and 48-h (MD = −16.51; 95%CI, −27.64, −5.39; p = 0.004) morphine consumption, and 24-h dynamic pain scores (MD = −0.52; 95% CI, −0.87, −0.17; p = 0.003). No significant differences were observed in resting pain, recovery metrics, satisfaction, or opioid-related adverse events. GRADE certainty for the primary outcome was moderate. QLB was associated with modest reductions in postoperative opioid consumption and 24-h dynamic pain after C/S; however, the clinical significance is limited (pain reduction below the minimally clinically important difference), and the certainty of evidence is moderate-to-low due to very high heterogeneity (I2 > 90%). QLB may be considered as one component of multimodal analgesia in selected patients, particularly those without intrathecal morphine co-administration. No additional benefits on resting pain, recovery metrics, satisfaction, or adverse events were identified. https://doi.org/10.37766/inplasy2026.6.0029, identifier: INPLASY202660029.