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Quadratus lumborum

Arunangshu Chakraborty, Rakhi Khemka, Taniya Datta
The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs) block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks...
October 2016: Indian Journal of Anaesthesia
Rafael Blanco, Tarek Ansari, Waleed Riad, Nanda Shetty
BACKGROUND AND OBJECTIVES: Effective postoperative analgesia after cesarean delivery enhances early recovery, ambulation, and breastfeeding. In a previous study, we established the effectiveness of the quadratus lumborum block in providing pain relief after cesarean delivery compared with patient-controlled analgesia (morphine). In the current study, we hypothesized that this method would be equal to or better than the transversus abdominis plane block with regard to pain relief and its duration of action after cesarean delivery...
October 11, 2016: Regional Anesthesia and Pain Medicine
Brian M Ilfeld
A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim...
October 3, 2016: Anesthesia and Analgesia
S D Adhikary, K El-Boghdadly, Z Nasralah, N Sarwani, A M Nixon, K J Chin
We performed bilateral transmuscular quadratus lumborum blocks in six cadavers using iodinated contrast and methylene blue. Computed tomography imaging was performed in four cadavers and anatomical dissection was completed in five. This demonstrated spread to the lumbar paravertebral space in 63% of specimens, laterally to the transversus abdominis muscle in 50% and caudally to the anterior superior iliac spine in 63% of specimens. There was no radiographic evidence of spread to the thoracic paravertebral space...
October 12, 2016: Anaesthesia
Alfred C Gellhorn, Pradeep Suri, Sean Rundell, Nathan Olafsen, M Jake Carlson, Steve Johnson, Adrielle Fry, Thiru Anaswammy, Christopher Gilligan, Bryan Comstock, Patrick Heagerty, Janna Friedly, Jeffrey G Jarvik
BACKGROUND: Minimal longitudinal data exist regarding the role of lumbar musculature in predicting back pain and function. In cross sectional study designs, there is often atrophy of the segmental multifidus muscle in subjects with low back pain compared with matched controls. However, the cross sectional design of these studies prevents drawing conclusions regarding whether lumbar muscle characteristics predict or modify future back pain or function. OBJECTIVE: The primary objective is to determine if the cross sectional area (CSA) of lumbar muscles predicts functional status or back pain at 6- or 12-month follow-up in older adults with spinal degeneration...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
José Miguel Cardoso, Miguel Sá, Hugo Reis, Liliana Almeida, José Carlos Sampaio, Célia Pinheiro, Duarte Machado
INTRODUCTION AND OBJECTIVES: Quadratus Lumborum block was recently described and has already shown good results as an analgesic technique in abdominal surgeries, having the potential to significantly reduce opioids consumption and be a valid alternative to epidural catheter. We performed a type II Quadratus Lumborum block for analgesia in a septic patient having a sub-total gastrectomy. CASE REPORT: An 80 year-old, ASA III, male patient, weighting 50kg, with a history of arterial hypertension and hypercholesterolemia, diagnosed with sepsis due to purulent peritonitis was submitted to an open laparotomy...
September 26, 2016: Revista Brasileira de Anestesiologia
Emilie Viollet, Arnaud Dupeyron, Corine Gagnard-Landra
OBJECTIVE: Pisa syndrome (PS) is a common abnormal posture of the trunk in Parkinson disease which is defined as a lateral flexion of the spine in the coronal plane and/or scoliosis. Few studies described focal treatment of dystonia of paraspinal muscles, with unpredictable results, while the participation of quadratus lumborum and external oblique homolateral seem to be interesting. The aim of this study is to estimate the effects of treatment by botulinum toxin of trunk muscles dystonia in PS...
September 2016: Annals of Physical and Rehabilitation Medicine
Kazunori Iwai, Koji Koyama, Takashi Okada, Koichi Nakazato, Ray Takahashi, Shingo Matsumoto, Yosuke Yamamoto, Kenji Hiranuma
BACKGROUND: Lumbar intervertebral disc degeneration (LDD) frequently occurs in athletes. Associations between LDD and trunk muscles still remain unclear. PURPOSE: This study examined whether there is an association between the prevalence of LDD and the symmetry and size of the cross-sectional areas (CSAs) of the trunk muscles in combat sports athletes. METHODS: Participants in this study were 151 collegiate male combat sports athletes. A total of 755 lumbar intervertebral discs from L1-2 to L5-S1 in 151 athletes were assessed using magnetic resonance imaging (MRI) and a comprehensive grading system of LDD (grades I-V)...
2016: SpringerPlus
Renan Lima Monteiro, Joana Hoverter Facchini, Diego Galace de Freitas, Bianca Callegaric, Sílvia Maria Amado João
Pelvic drop exercises are often used to strengthen the gluteus medius muscle with the aim of increasing or prioritizing its recruitment. However, the effect of hip rotation on the performance of the action of the gluteus medius is unknown. The aim of the study was to evaluate the effect of hip rotation on the recruitment of the gluteus medius muscle, tensor fasciae latae and quadratus lumborum. Seventeen healthy subjects performed two sets of four repetitions of pelvic drop exercise in random order with lateral (PDLR), medial (PDMR) and neutral (PDN) rotation of the hip...
August 24, 2016: Journal of Sport Rehabilitation
Kunitaro Watanabe, Shingo Mitsuda, Joho Tokumine, Alan Kawarai Lefor, Kumi Moriyama, Tomoko Yorozu
INTRODUCTION: Atherosclerosis has a complex etiology that leads to arterial obstruction and often results in inadequate perfusion of the distal limbs. Patients with atherosclerosis can have severe complications of this condition, with widespread systemic manifestations, and the operations undertaken are often challenging for anesthesiologists. CASE REPORT: A 79-year-old woman with chronic heart failure and respiratory dysfunction presented with bilateral gangrene of the distal lower extremities with obstruction of the left common iliac artery due to atherosclerosis...
August 2016: Medicine (Baltimore)
L Carline, G A McLeod, C Lamb
BACKGROUND: Posterior variants of abdominal wall block include the quadratus lumborum type I, quadratus lumborum type II and quadratus lumborum transmuscular blocks. Our objectives were to compare the spread of injectate and nerve involvement, after conducting blocks using ultrasound guidance in soft embalmed cadavers. METHODS: After randomization, an experienced anaesthetist conducted three quadratus lumborum 1, three quadratus lumborum 2 and four transmuscular blocks on the left or right sides of five cadavers...
September 2016: British Journal of Anaesthesia
Margaret M Hockett, Sheena Hembrador, Alex Lee
A 69-year-old man with a history of chronic pain and opioid use presented for total hip arthroplasty. In the interests of ensuring early mobilization and pain control, we chose a continuous quadratus lumborum block technique, a novel ultrasound-guided block that has not yet been described for total hip arthroplasty, hypothesizing that it would be motor-sparing. While the perineural catheter was infused, the patient required no IV opioids. He was able to ambulate on the first postoperative day, reporting pain scores between 0 and 3/10...
September 15, 2016: A & A Case Reports
Jens Børglum, Ismail Gögenür, Thomas F Bendtsen
PURPOSE OF REVIEW: Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research. RECENT FINDINGS: Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated...
October 2016: Current Opinion in Anaesthesiology
M T Alif Adlan, W A K Wan Mohd Rasis, M D Mohd Ramadhan
Staphylococcus Aureus is a Gram-positive cocci bacteria which had been found to be the causative organism in over 88% of patients with primary iliopsoas abscess. We report the case of a 53-year-old diabetic woman with end-stage renal failure diagnosed with left iliopsoas abscess with a catheter-related infection. Computed tomogram (CT) of abdomen and pelvis revealed hypodense lesions of left psoas, iliacus and quadratus lumborum suggestive of psoas abscesses. In addition, osteomyelitis changes at left sacroiliac and hip joint were seen...
April 2016: Medical Journal of Malaysia
Kariem El-Boghdadly, Hesham Elsharkawy, Anthony Short, Ki Jinn Chin
No abstract text is available yet for this article.
July 2016: Regional Anesthesia and Pain Medicine
Joaquin Sanchis-Moysi, Fernando Idoate, David Álamo-Arce, José A L Calbet, Cecilia Dorado
The effects of exercise on the core musculature have not been investigated in prepubescents. The main purpose of the present study was to determine the volume and degree of asymmetry of rectus abdominis, obliques and transversus abdominis, quadratus lumborum, iliopsoas, gluteus and paravertebralis muscles in prepubescent tennis players and in untrained boys. The muscle volume was determined using magnetic resonance imaging (MRI) in 7 male prepubescent tennis players and 10 untrained controls (mean age 11.0 ± 0...
May 30, 2016: Journal of Sports Sciences
Hyun-Kyung Kim, Yanxin Zhang
Large spinal compressive force combined with axial torsional shear force during asymmetric lifting tasks is highly associated with lower-back injury (LBI). The aim of this study was to estimate lumbar spinal loading and muscle forces during symmetric lifting (SL) and asymmetric lifting (AL) tasks using a whole-body musculoskeletal modelling approach. Thirteen healthy males lifted loads of 7 kg and 12 kg under two lifting conditions (SL and AL). Kinematic data and ground reaction force data were collected and then processed by a whole-body musculoskeletal model...
May 18, 2016: Ergonomics
Ramon Go, Yolanda Y Huang, Paul D Weyker, Christopher Aj Webb
As the American healthcare system continues to evolve and reimbursement becomes tied to value-based incentive programs, perioperative pain management will become increasingly important. Regional anesthetic techniques are only one component of a successful multimodal pain regimen. In recent years, the use of peripheral and paraneuraxial blocks to provide chest wall and abdominal analgesia has gained popularity. When used within a multimodal regimen, truncal blocks may provide similar analgesia when compared with other regional anesthetic techniques...
October 2016: Pain Management
Vanessa Martins Pereira Silva Moreira, Saulo Delfino Barboza, Juliana Borges Oliveira, Janser Moura Pereira, Valdeci Carlos Dionisio
BACKGROUND: Secondary hyperalgesia in individuals with less severe levels of knee osteoarthritis remains unclear. The objective of this study was to measure the pressure pain threshold (PPT) of individuals with mild or moderate knee osteoarthritis (KOA) and compare with no osteoarthritis. METHODS: Ten healthy controls and 30 individuals with mild or moderate KOA divided into two groups (unilateral and bilateral involvement) were included. Dermatomes (L1, L2, L3, L4, L5, S1, and S2), myotomes (vastus medialis, vastus lateralis, rectus femoris, adductor longus, tibialis anterior, peroneus longus, iliacus, quadratus lumborum, and popliteus muscles), and sclerotomes (L1-L2, L2-L3, L3-L4, L4-L5 supraspinous ligaments), over the L5-S1 and S1-S2 sacral areas, pes anserinus bursae, and at the patellar tendon) PPT were assessed and compared between individuals with and without KOA...
March 24, 2016: Revista Brasileira de Reumatologia
Stuart J Currie, Casey A Myers, Catherine Durso, Brian A Enebo, Bradley S Davidson
OBJECTIVE: The purpose of this study was to evaluate differences in muscle activity in participants with and without low back pain during a side-lying lumbar diversified spinal manipulation. METHODS: Surface and indwelling electromyography at eight muscle locations were recorded during lumbar side-lying manipulations in 20 asymptomatic participants and 20 participants with low back pain. The number of muscle responses and muscle activity onset delays in relation to the manipulation impulse were compared in the 2 pain groups using mixed linear regressions...
May 2016: Journal of Manipulative and Physiological Therapeutics
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