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quadratus lumborum block

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
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
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
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
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
Matthew Abrahams, Ryan Derby, Jean-Louis Horn
UNLABELLED: We summarized the evidence for ultrasound (US) guidance for truncal blocks in 2010 by performing a systematic literature review and rating the strength of evidence for each block using a system developed by the United States Agency for Health Care Policy and Research. Since then, numerous studies of US guidance for truncal blocks have been published. In addition, 3 novel US-guided blocks have been described since our last review. To provide updated recommendations, we performed another systematic search of the literature to identify studies pertaining to US guidance for the following blocks: paravertebral, intercostal, transversus abdominis plane, rectus sheath, ilioinguinal/iliohypogastric, as well as the Pecs, quadratus lumborum, and transversalis fascia blocks...
March 2016: Regional Anesthesia and Pain Medicine
Mohamed Shaaban, Wael Ali Sakr Esa, Kamal Maheshwari, Hesham Elsharkawy, Loran Mounir Soliman
We present a case of acute postoperative abdominal pain after proctosigmoidectomy and colorectal anastomosis that was treated by bilateral continuous quadratus lumborum block. The block was performed in the lateral position under ultrasound guidance with a 15-mL bolus of 0.5% bupivacaine injected anterior to the quadratus lumborum muscle followed by bilateral catheter placement. Each catheter received a continuous infusion of 0.1% bupivacaine at 8 mL/h and an on-demand bolus 5 mL every 30 minutes. Sensory level was confirmed by insensitivity to cold from T7 through T12...
October 1, 2015: A & A Case Reports
T Parras, R Blanco
INTRODUCTION: A double-blind randomised controlled trial was conducted to compare the analgesic effect of the transversus abdominis plane block posterior approach or the quadratus lumborum block I versus femoral block, both ultrasound-guided. MATERIAL AND METHODS: Prospective study with parallel groups with 104 patients with neck of femur fracture undergoing hemiarthroplasty (although 7 participants did not finish the study). The inclusion criteria were patients older than 65 years old, ASA I-III status, who required and gave their consent for hemiarthroplasty...
March 2016: Revista Española de Anestesiología y Reanimación
Rafael Blanco, Tarek Ansari, Emad Girgis
BACKGROUND: Effective postoperative analgesia after caesarean section is important because it enables early ambulation and facilitates breast-feeding. Several case reports have shown that local anaesthetic injection around the quadratus lumborum muscle is effective in providing pain relief after various abdominal operations and in patients with chronic pain. The quadratus lumborum block (QLB) is performed in close proximity to the surface and uses a fascial compartment path to extend the distribution of local anaesthesia into the posterior abdominal wall and paravertebral space...
November 2015: European Journal of Anaesthesiology
Vasanth Rao Kadam
No abstract text is available yet for this article.
January 2015: Journal of Anaesthesiology, Clinical Pharmacology
Arunangshu Chakraborty, Jyotsna Goswami, Viplab Patro
Quadratus lumborum block is a recently introduced variation of transversus abdominis plane block. In this report, we describe the use of ultrasound-guided continuous quadratus lumborum block for postoperative analgesia in a 7-year-old child scheduled to undergo radical nephrectomy (left-sided) for Wilms tumor. The result was excellent postoperative analgesia and minimal requirement for rescue analgesics. The modification described may allow easier placement of a catheter for continuous infusion of local anesthetic...
February 1, 2015: A & A Case Reports
Rita Carvalho, Elena Segura, Maria do Céu Loureiro, José Pedro Assunção
BACKGROUND AND OBJECTIVES: The quadratus lumborum block was described by R. Blanco in its two approaches (I and II). The local anesthetic deposition in this location can provide blockade to T6-L1 dermatomes. We performed this fascial block guided by ultrasound for treating a chronic neuropathic pain in the abdominal wall. CASE REPORT: Male patient; 61 years old; 83kg; with a history of thrombocytopenia due to alcoholic cirrhosis, among others; had chronic pain in the abdominal wall after multiple abdominal hernia repairs in the last year and a half, with poor response to treatment with neuromodulators and opioids...
December 5, 2014: Revista Brasileira de Anestesiologia
Emine Aysu Salvız, Yavuz Gürkan, Murat Tekin, Levent Buluç
Anesthetizing the lumbar plexus at its origin facilitates a more "complete" psoas compartment block compared to peripheral approaches. It is usually performed using surface anatomical landmarks, and the site for local anesthetic injection is confirmed by observing quadriceps muscle contraction to peripheral nerve stimulation. Ultrasound may provide guidance alone or together with the aid of nerve stimulation during nerve blocks. We present a 48-year-old male patient, American Society of Anesthesiologists (ASA) physical status II, who refused spinal anesthesia, and underwent knee arthroscopy with ultrasound-guided psoas compartment block and general anesthesia...
2014: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
José Cid, José L De La Calle, Esther López, Cristina Del Pozo, Alfredo Perucho, María Soledad Acedo, Dolores Bedmar, Javier Benito, Javier De Andrés, Susana Díaz, Juan Antonio García, Leticia Gómez-Caro, Adolfo Gracia, José María Hernández, Joaquín Insausti, María Madariaga, Pedro Moñino, Manuel Ruiz, Estrella Uriarte, Alfonso Vidal
BACKGROUND: Low back pain (LBP) symptoms and signs are nonspecific. If required, diagnostic blocks may find the source of pain, but indicators of suspect diagnosis must be defined to identify anatomical targets. OBJECTIVE: To reach a consensus from an expert panel on the indicators for the most common causes of LBP. MATERIAL AND METHODS: A 3-round (2 telematic and 1 face-to-face) modified Delphi survey with a questionnaire on 78 evidence-based indicators of 7 LBP etiologies was completed by 23 experts...
January 2015: Pain Practice: the Official Journal of World Institute of Pain
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