Ultrasound guided quadratus lumborum block for analgesia after cesarean delivery: case series

Sebbag, Ilana; Qasem, F.; Dhir, Shalini

doi:10.1016/j.bjane.2015.11.005

Cited by 9 publications

(4 citation statements)

References 12 publications

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“…Of note, the values obtained below the L 4 vertebral body were 3.77 ± 1.25 and 3.98 ± 1.17 cm 2 , respectively, with no statistical difference. Furthermore, Stark et al [ 20 ] in their CT study with a 3D reconstruction of the quadratus lumborum found the mean cross-sectional area of the muscle on the left and right sides to be 2.4 ± 0.9 and 3.3 ± 1.5 cm 2 , respectively.…”

Section: Discussionmentioning

confidence: 99%

Quantitative anatomy of the growing quadratus lumborum in the human foetus

et al. 2017

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PurposesThe purpose of the study was to quantitatively evaluate the size of the quadratus lumborum and to precisely display its growth dynamics in the human foetus.Materials and methodsUsing anatomical dissection, digital-image analysis (NIS Elements AR 3.0) and statistical analysis (Student’s t test, regression analysis), the length, width, surface area, and cross-sectional area of the quadratus lumborum were measured, and the width-to-length ratio was calculated in 58 human foetuses of both sexes (26♂, 32♀) aged 16–27 weeks.ResultsNeither sex nor right-left significant differences were found in relation with the numerical data of the growing quadratus lumborum. The length, width, and cross-sectional area of the quadratus lumborum muscle increased logarithmically, while its surface area increased proportionately to fetal age. The following growth models were computed for the quadratus lumborum: y = −70.397 + 68.501 × ln(age) ± 1.170 for length, y = −20.435 + 8.815 × ln(age) ± 0.703 for width, y = −196.035 + 14.838 × age ± 13.745 for surface area, and y = −48.958 + 20.909 × ln(age) ± 1.100 for cross-sectional area.ConclusionsThe fetal quadratus lumborum reveals neither sex nor bilateral differences. An increase in length and width of the growing quadratus lumborum follows in a commensurate fashion. The quadratus lumborum grows logarithmically with respect to its length, width, and cross-sectional area, and proportionately to age with respect to its surface area.

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Section: Discussionmentioning

confidence: 99%

Quantitative anatomy of the growing quadratus lumborum in the human foetus

et al. 2017

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“…Still, we resorted to these two techniques to compare each other as they have established efficacy with proven safety. [ 20 21 ]…”

Section: Discussionmentioning

confidence: 99%

Relative efficacy of ultrasound-guided ilioinguinal-iliohypogastric nerve block versus transverse abdominis plane block for postoperative analgesia following lower segment cesarean section: A prospective, randomized observer-blinded trial

Kiran¹,

Sivashanmugam

Kumar

et al. 2017

Anesth Essays Res

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Background:Quality of postoperative analgesia after cesarean section makes difference to mother in child bonding, early ambulation, and discharge. Ilioinguinal iliohypogastric (ILIH) and transverse abdominis plane (TAP) block had been tried to reduce the opioid analgesics, but the relative efficacy is unknown. Hence, this study was designed to compare the efficacy of these two regional analgesic techniques in sparing postoperative rescue analgesic requirement following lower segment cesarean section (LSCS).Methods:Sixty patients who underwent LSCS were randomly allocated into two groups to receive either US-guided TAP block or ILIH nerve block using sealed envelope technique at the end of the surgery. In the postoperative ward, whenever patient complained of pain, pain nurse in-charge administered the rescue analgesics as per the study protocol. A blinded observer visited the patient at 0, 2, 4, 6, 8, 10, 12, and 24 h postoperative intervals and recorded the quality of pain relief and the amount of rescue analgesic consumed.Results:All patients in both the study groups required one dose of rescue analgesics in the form of injection diclofenac sodium 50 mg intravenously but subsequently 57% of patients did not require any further analgesics till 24 h in the TAP block group whereas in ILIH group, only 13% did not require further analgesics (P = 0.00), correspondingly the cumulative tramadol dose was significantly higher at all the time interval in the ILIH group when compared to the TAP group.Conclusion:Quality of postoperative analgesia provided by TAP block was superior to ILIH block following LSCS.

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“…При этом доступе виден классический трилистник: поперечный отросток четвертого пояснич ного позвонка выглядит как стебель, большая пояснич ная мышца -передний листок, мышца, разгибающая позвоночник, -задний листок, а квадратная мышцалатеральный [32,33]. Стоит отметить, что QLB исполь зуется в качестве эффективного метода обезболивания в раннем послеоперационном периоде после кесарева сечения [34][35][36][37][38][39], гинекологических операций, в первую очередь после экстирпации матки [40], резекции тон кой [41] и толстой кишки [42,43], неф рэктомии [44][45][46], гастрэктомии [47], герниопластики [48,49]. Описано применение блокады квадратной мышцы живота по сле бифеморального шунтирования [50] и при опера циях на поясничном отделе позвоночника [51,52].…”

Section: блокада мышцы разгибаю щей позвоночникunclassified

Regional methods of anesthesia in labor pain relief: a systematic review

Махарин

Лебедева

Кочубейник

2022

Annals of Critical Care

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INTRODUCTION: Today epidural anesthesia is the “golden standard” of anesthesia. But what can we do if the application of an epidural catheter is contraindicated? The use of narcotic analgesics can hardly be deemed a worthy alternative. OBJECTIVE: To identify alternative regional methods of anesthesia in labour pain relief. MATERIALS AND METHODS: We have performed a systematic review of literature in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline principles. The bibliographic search was conducted in January-March 2022. The search was performed in the MEDLINE, EMBASE, eLibrary.ru, Cochrane Library databases. The search keywords were: anesthesia of childbirth, pudendal block, paracervical block, paravertebral block, quadratic lumbar muscle (QLB) block, erector spinae plane block (ESPB). We found 122 works, and after removing 94 works for various reasons, 28 works were analyzed. RESULTS: We found 122 works, and after removing 94 works for various reasons, 28 works were analyzed. We identified six randomized controlled trials related to the subject matter, but the endpoints were heterogeneous preventing a statistical analysis; therefore, we performed a qualitative review of the literature. Works dedicated to paravertebral and paracervial blocks showed sufficient effectiveness of anesthesia for the second period of labor. Good results of anesthesia of the second period of labor were also described with the use of ESPB and bilateral QLB. Nevertheless, it is impossible to draw statistically significant conclusions on the use of ESPB and QLB due to the small sample. Articles devoted to the use of pudendal block in labour revealed its low effectiveness. CONCLUSIONS: The described results show that paravertebral, ESPB and QLB blocks can be used as alternative regional methods of anesthesia in labour. However, further research is required to assess the effectiveness of their use in childbirth.

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Ultrasound guided quadratus lumborum block for analgesia after cesarean delivery: case series

Cited by 9 publications

References 12 publications

Quantitative anatomy of the growing quadratus lumborum in the human foetus

Quantitative anatomy of the growing quadratus lumborum in the human foetus

Relative efficacy of ultrasound-guided ilioinguinal-iliohypogastric nerve block versus transverse abdominis plane block for postoperative analgesia following lower segment cesarean section: A prospective, randomized observer-blinded trial

Regional methods of anesthesia in labor pain relief: a systematic review

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