quadratus lumborum block

Steve Coppens, Steffen Rex, Steffen Fieuws, Arne Neyrinck, Andre D'Hoore, Geertrui Dewinter
BACKGROUND: Thoracic epidural anesthesia is no longer considered the gold standard for perioperative analgesia in laparoscopic colorectal procedures. In the search for alternatives, the efficacy of the transverse abdominal plane (TAP) block and other abdominal wall blocks such as the transmuscular quadratus lumborum (TQL) block continues to be investigated for postoperative pain management. Most of the initial studies on TAP blocks reported positive effects; however, the amount of studies with negative outcomes is increasing, most probably due to the fact that the majority of abdominal wall blocks fail to mitigate visceral pain...
June 26, 2020: Trials
Eshel A Nir, Alexander Ioscovich, Joel Shapiro
Intrathecal morphine administration at the time of neuraxial anesthesia performance is the gold standard for post-cesarean delivery (CD) analgesia. When intrathecal morphine administration is inappropriate or contraindicated, the use of systemic analgesic options increase side effects and risks to both the parturient and the breastfeeding neonate. Moreover, systemic analgesia is often inadequate. The increased clinical use of ultrasound has made way for regional analgesia techniques, mostly in the form of local anesthesia injected between muscular planes...
June 2020: Harefuah
Jared A Herman, Ivan Urits, Alan D Kaye, Richard D Urman, Omar Viswanath
No abstract text is available yet for this article.
June 17, 2020: Journal of Clinical Anesthesia
Shuguang Yang, Kun Chen, Li Wan
It was widely recognized that the procedure of ultrasound-guided lumbar and sacral plexus block is required to be performed in a lateral decubitus position that patients' hips and knees were bended. It is difficult, however, for patients with hip fractures to change position because of severe pain and confined movements. We here reported a new modified combination of ultrasound-guided lumbosacral plexus block with anterior quadratus lumborum block in supine position that had been successfully applied in one elderly patient who underwent hip surgery...
June 12, 2020: Journal of Anesthesia
Amin M Alansary, Atef Badawy, Marwa A K Elbeialy
BACKGROUND: General anesthesia (GA) is the preferred anesthetic modality for open renal surgeries to ensure a patent airway while the patient is in the lateral decubitus position. However, these surgeries are usually accompanied by severe postoperative pain with increased requirements for multimodal pain management strategies. Regional blocks provide better postoperative pain control with less systemic opioid consumption. OBJECTIVES: The aim of this study was to describe the ultrasound (US)-guided transincisional quadratus lumborum block (TiQLB) as a new approach, and to compare the addition of dexmedetomidine to bupivacaine versus bupivacaine alone for TiQLB in combination with GA regarding postoperative analgesia and adverse effects in open renal surgery...
June 2020: Pain Physician
Ahmad S Alabd, Moustafa A Moustafa, Aly M M Ahmed
BACKGROUND: Effective pain management is essential for successful rehabilitation and enhanced recovery after joint arthroplasty. The Quadratus Lumborum Block (QLB) has mostly been described for abdominal surgery, but has also recently been applied to hip surgery patients. METHODS: In the following cases series, we suggest a modification of the TQL block described as Paraspinous Sagittal Shift QL block. We hypothesize that this approach may allow better LA spread to the lumbar nerve roots...
May 12, 2020: Revista Brasileira de Anestesiologia
Yanqing Wang, Xiaojia Wang, Kexian Zhang
An amendment to this paper has been published and can be accessed via the original article.
May 27, 2020: BMC Anesthesiology
Murillo de Lima Favaro, Silvio Gabor, Diogo Barros Florenzano Souza, Anderson Alcoforado Araújo, Ana Luiza Castro Milani, Marcelo Augusto Fontenelle Ribeiro Junior
Minimally invasive surgery for inguinal hernia repair is advantageous in terms of return to usual activities and lower rates of chronic pain; however, it requires general anesthesia. This study sought to analyze the benefits of ultrasound guided locoregional anesthesia of the quadratus lumborum muscle (QL block) as a single anesthetic technique for endoscopic totally extraperitoneal (TEP) inguinal hernia repair with regard to postoperative pain, length of hospital stay, and hospital cost. A total of 46 patients, aged 18 to 80 years, with unilateral inguinal hernia, one group that received general anesthesia and one that received sedation and QL block for TEP inguinal hernia repair...
May 22, 2020: Scientific Reports
Yuki Aoyama, Shinichi Sakura, Aumjit Wittayapairoj, Shoko Abe, Saki Tadenuma, Yoji Saito
BACKGROUND: Quadratus lumborum block (QLB) has recently attracted attention as a part of multimodal analgesia after abdominal surgery. It has been shown that programmed intermittent boluses of local anesthetic can produce better analgesia and wider sensory blockade compared with continuous basal infusion with some peripheral nerve blocks. The present study was conducted to see if this theory holds true for QLB in patients undergoing laparoscopic colorectal surgery. METHODS: Fifty patients undergoing laparoscopic colorectal surgery were divided into 2 groups to receive continuous basal infusion (group C) or programmed intermittent boluses (group PIB) of local anesthetic...
May 18, 2020: Journal of Anesthesia
Johanna Blair de Haan, Subhan Tabba, Linden O Lee, Semhar Ghebremichael, Sudipta Sen, Daniel Shoham, Nadia Hernandez
Neuraxial analgesia has been established as the standard of care for labor analgesia. However, patients presenting with coagulopathy require anesthesiologists to explore alternate analgesic techniques. Systemic opioids may result in neonatal respiratory depression, and inhaled nitrous oxide may lead to nausea, vomiting, and over sedation and may not be readily available in all labor and delivery units. In this case report, we describe a case where posterior quadratus lumborum blocks provided effective analgesia in a parturient with Hemophilia A during the first stage of labor...
May 2020: A&A practice
Yanqing Wang, Xiaojia Wang, Kexian Zhang
BACKGROUND: Trunk block technique has been used in postoperative analgesia for patients undergoing surgery, specifically, transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) have been proved effective. The purpose of this meta-analysis is to evaluate the effects of TAPB and QLB in postoperative analgesia. METHODS: Online databases, including MEDLINE, EMBASE, Cochrane Library (&Trail), Web of Science, CNKI, Wanfang and QVIP were applied to collect the randomized controlled trials (RCTs) from inception to Dec...
May 4, 2020: BMC Anesthesiology
Liangjing Yuan, Ye Zhang, Chengshi Xu, Anshi Wu
OBJECTIVE: To investigate the postoperative analgesic effect of ultrasound-guided quadratus lumborum block (QLB) in patients undergoing arthroscopic hip surgery. METHODS: Patients who were scheduled to undergo elective arthroscopic hip surgery were randomly assigned to the QLB (Q) or control (C) group (n = 40 each). After general anesthesia induction, unilateral QLB was performed under ultrasound guidance in the Q group. The amount of opioid use via patient-controlled analgesia (PCA) and the resting and movement pain visual analog scale (VAS) scores when the patient left the postanesthesia care unit (PACU) and 4, 8, 12, and 24 hours after surgery were recorded...
May 2020: Journal of International Medical Research
Marissa M Khalil, Richard D Urman, Engy T Said, Rodney A Gabriel
No abstract text is available yet for this article.
April 17, 2020: Journal of Clinical Anesthesia
O Bagbanci, H Kursad, A M Yayik, E O Ahiskalioglu, M E Aydin, A Ahiskalioglu, E Karadeniz
OBJECTIVE: The efficacy of quadratus lumborum muscle block (QLB) in abdominal surgery is known; however, the efficacy of different QLB types is unclear. The objective of this study was to investigate the effects of ultrasound-guided QLB type 2 and type 3 on postoperative opioid consumption and pain scores in patients undergoing inguinal hernia surgery. MATERIAL AND METHODS: In this study 60 patients undergoing open inguinal hernia surgery were randomly assigned to 3 groups...
April 17, 2020: Der Anaesthesist
Christian H S Andersen, Gunnar H Laier, Martin V Nielsen, Mette Dam, Christian K Hansen, Katrine Tanggaard, Jens Børglum
BACKGROUND: The objective of this trial is to optimize the transmuscular quadratus lumborum (TQL) block, by investigating the minimal effective volume (MEV90 ) of ropivacaine 0.75% for single-shot TQL block in percutaneous nephrolithotomy (PNL) patients. METHODS: This double-blind, randomized and controlled dose-finding trial is based on a biased coin up-and-down sequential design, where the volume of local anaesthetic administered to each patient depends on the response from the previous one...
April 16, 2020: Acta Anaesthesiologica Scandinavica
Guðný E Steingrímsdóttir, Christian K Hansen, Jens Børglum
BACKGROUND: Management of moderate to severe postoperative pain after elective caesarean section (ECS) is internationally primarily based on either epidural catheters or opioids. However, both techniques are associated with some undesirable adverse events. Bilateral transmuscular quadratus lumborum (TQL) block has proven to reduce opioid consumption significantly in the first 24 postoperative hours following ECS and prolong time to first opioid (TFO).1 We present a randomised controlled trial aiming to investigate whether continuous analgesia via bilateral TQL catheters can prolong TFO after ECS...
April 9, 2020: Acta Anaesthesiologica Scandinavica
Jian He, Lei Zhang, Wan You He, Dong Lin Li, Xue Qin Zheng, Qi Xia Liu, Han Bin Wang
Methods: Eighty-eight patients undergoing THA were randomized to receive 0.33% ropivacaine (Group QLB, n  = 44) or saline (Group Con, n  = 44) for QL3 block. Spinal anesthesia was then performed. Pain intensity was assessed using the visual analog scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on standing and walking at 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, the 10-meter walking speed on day 6, and patient satisfaction after surgery...
2020: Pain Research & Management: the Journal of the Canadian Pain Society
Yuki Aoyama, Shinichi Sakura, Shoko Abe, Saki Tadenuma, Yoji Saito
BACKGROUND: Continuous femoral nerve block (FNB) has been effectively used after total hip arthroplasty (THA). Recently the anterior approach to quadratus lumborum block (QLB) has been shown to produce postoperative pain relief after THA. Continuous QLB would benefit from a catheter insertion site that is farther away from the surgical site compared with continuous FNB. In this randomized controlled study, we compared analgesic effects of the two techniques in patients undergoing THA...
June 2020: Journal of Anesthesia
Marcin Kolacz, Marcin Mieszkowski, Marek Janiak, Krzysztof Zagorski, Beata Byszewska, Malgorzata Weryk-Dysko, Dariusz Onichimowski, Janusz Trzebicki
BACKGROUND: Several studies have shown an analgesic efficacy of a transversus abdominis plane block (TAPB) in reducing opioid requirements during and after cadaveric renal transplantation surgery, but the effect of a quadratus lumborum block (QLB) in this type of surgery is unclear. OBJECTIVES: The main objective of this prospective, randomised, double-centre clinical study was to compare the analgesic efficacy of a one-sided lateral approach TAPB with a unilateral QLB type 2 in cadaveric renal transplantation surgery...
March 13, 2020: European Journal of Anaesthesiology
Christopher Adam Godlewski
Abdominal organ transplantation - and more specifically small bowel transplant - can be quite painful, generally requiring significant opioid administration with the attendant negative ramifications. We present contrasting experiences with a gentleman who underwent transplantation for Crohn's disease and his retransplantation with the addition of post-operative anterior Quadratus Lumborum (QL) block. After the index procedure, he had significant pain and discomfort. The addition of the QL block lead to substantial improvement in both subjective and objective endpoints...
January 2020: Journal of Anaesthesiology, Clinical Pharmacology
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