Quadratus lumborum block: are we aware of its side effects? A report of 2 cases

Sá, Miguel; Cardoso, José Miguel; Reis, Hugo; Esteves, Marta; Sampaio, José; Gouveia, Isabel; Carballada, Pilar; Pinheiro, Célia; Machado, Duarte

doi:10.1016/j.bjane.2016.09.008

Cited by 18 publications

(17 citation statements)

References 5 publications

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“…Clinicians should be aware that complications, such as retroperitoneal hematoma, organ injury, and local anesthetic toxicity, could occur. Local anesthetic can spread to the paravertebral area; hence, we should be careful about complications such as bradycardia and hypotension 29. A case in the literature reported the femoral block-induced quadriceps muscle weakness that disappeared after 18 hours 30.…”

Section: Discussionmentioning

confidence: 99%

Comparison of quadratus lumborum block and caudal block for postoperative analgesia in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries: a randomized controlled trial

Öksüz

Arslan

Urfalıoğlu

et al. 2020

Reg Anesth Pain Med

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Background and objectivesCaudal epidural anesthesia is a widely used popular technique for postoperative analgesia but it has potential side effects and duration of analgesia is short. Quadratus lumborum block (QLB) was found to be an effective method for postoperative analgesia in lower abdominal surgeries. In this double-blind prospective randomized trial, we aimed to compare the postoperative analgesic efficacies of QLB and the caudal block in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries under general anesthesia.Materials and methodsAfter approval was obtained from the ethics committee, in this prospective randomized double-blind trial, 53 patients under general anesthesia undergoing inguinal hernia repair and orchiopexy surgeries randomly received caudal block or QLB. Demographic data, postoperative analgesic requirement, Face, Legs, Activity, Cry, and Consolability (FLACC) scores at 30 min, 1, 2, 4, 6, 12 and 24 hours, parent satisfaction scores and complications were recorded.ResultsThe study included 52 patients, after excluding one patient because of a failed caudal block. There were no significant differences between the groups based on demographic data (p>0.05). The number of patients who required analgesics in the first 24 hours was significantly lower in QLB group (p=0.001). Postoperative 4, 6, 12 hours FLACC scores were significantly lower in the QLB group (p<0.001, p=0.001 and p<0.001, respectively). Parent satisfaction scores were higher in the QLB group (p=0.014).ConclusionAccording to the results of this study, QLB can provide much more effective analgesia than caudal block without adjuvants in multimodal analgesia management of children undergoing inguinal hernia repair and orchiopexy surgeries.Trial registration numberNCT03294291.

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Section: Discussionmentioning

confidence: 99%

Comparison of quadratus lumborum block and caudal block for postoperative analgesia in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries: a randomized controlled trial

Öksüz

Arslan

Urfalıoğlu

et al. 2020

Reg Anesth Pain Med

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“…Based on the current randomized trials and case reports, quadratus lumborum blocks have been used for multiple surgeries, including cesarean section [1, 2, 3••, 6••] and gynecological [31] and lower abdominal surgeries [5••, 32]. It has also been used for analgesia for colostomy closure [16], hernia repairs [33,34], gastrectomy [35], and nephrectomy [17,[36][37][38][39]. It has been used for various lower limb surgeries like hip arthroplasty [4,14,18,20,[40][41][42], above knee amputation in combination with sciatic block [43], iliac crest bone graft, and iliac and acetabulum fracture [44].…”

Section: Indications and Clinical Evidencementioning

confidence: 99%

“…Hypotension has been reported and is possibly related to spread of local anesthetic in the paravertebral spaces [35]. Other considerations should be local anesthetic toxicity due to large volume used specially in cases of bilateral blocks [49].…”

Section: Complicationsmentioning

confidence: 99%

Quadratus Lumborum Block: a Technical Review

Gupta

Sondekoppam

Kalagara

2019

Curr Anesthesiol Rep

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Purpose of Review Ultrasound-guided quadratus lumborum block (QLB) is gaining popularity in regional anesthesia for various surgical procedures. The purpose of this review is to understand the relevant clinical anatomy, different mechanisms of actions, and techniques used for the block and clinical evidence so far. Recent Findings The current data suggests a wide dermatomal distribution of the local anesthetic from T7-L2. The evidence regarding its utility is still evolving but has shown reduced opioid requirements for cesarean sections, lower abdominal surgery, and hip surgery. Prolonged analgesia has been reported as compared with more conventional transversus abdominis plane (TAP) block. This block has also been reported for above knee amputation, femoral-pop bypass, lumbar laminectomy and fusion, iliac crest bone graft, and iliac and acetabulum fracture. Summary Quadratus lumborum can be performed through different approaches which requires sound knowledge of anatomy. Further research to determine which approach yields best results is warranted.

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“…[ 8 9 ] Unexplained hypotension following this block has also been reported. [ 10 ] We chose Borglum's QLB3, reporting anaesthesia from T7 to L1 based on traces of contrast in the thoracic paravertebral space. [ 11 ] There are no such studies performed at L2 level.…”

Section: Discussionmentioning

confidence: 99%