Importance of the transversalis fascia in relation to a successful application of the transmuscular quadratus lumborum block

Dam, Mette; Hansen, Christian K.; Poulsen, Thomas; Azawi, Nessn; Børglum, Jens

doi:10.1136/rapm-2021-102598

Cited by 1 publication

(3 citation statements)

References 4 publications

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“…Quadratus Lumborum (QLM) is a posterior abdominal wall muscle that originates from the posteromedial iliac crest and inserts into the 12 th rib and the transverse processes of the 1 st to 4 th lumbar vertebrae. [ 10 11 ]…”

Section: Methodsmentioning

confidence: 99%

“…According to the three-layered model, the posterior layer surrounds the erector spinae muscles (ESM), the middle layer passes between the ESM and QLM, and the anterior layer lies anterior to both the QLM and psoas muscles. [ 10 11 ]…”

Section: Methodsmentioning

confidence: 99%

“…This explains the clinical effect of QLB. [ 10 11 ] Because of its spread to paravertebral space, QLB can confer visceral analgesia and sympathetic block as well, in addition to abdominal wall analgesia. Drug can spread to lumbar plexus.…”

Section: Methodsmentioning

confidence: 99%

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Peripheral nerve blocks for analgesia following cesarean delivery A narrative review

Agarwal,

Babuwe-Ngobi,

Belani

et al. 2024

Journal of Anaesthesiology Clinical Pharmacology

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Spinal and epidural blocks are commonly employed for pain relief during and following cesarean section. Intrathecal morphine (ITM) has been the gold standard for the same for many years. In recent times, many peripheral nerve blocks (PNBs) have been tried for postoperative analgesia following cesarean delivery (PACD). This article has reviewed the common PNBs used for PACD. The role of PNBs along with ITM has been studied and the current best strategy for PACD has also been explored. Currently, Ilio-inguinal nerve and anterior transversus abdominis plane block in conjunction with intrathecal morphine have been found to be the most effective strategy, providing lower rest pain at 6 hours as compared to ITM alone. In patients not receiving intrathecal morphine, recommended PNBs are lateral transversus abdominis plane block, single shot local anesthetic wound infiltration, or continuous wound infiltration with catheter below rectus fascia. PNBs are recommended for PACD. They have an opioid-sparing effect and are devoid of adverse effects associated with central neuraxial blocks such as hypotension, bradycardia, and urine retention. However, caution must be observed with PNBs for possible local anesthetic toxicity due to the large volumes of drug required. Key Messages: Peripheral nerve blocks form an effective component of multi-model analgesic regimens for pain control following cesarean section. Ilio-inguinal nerve and anterior transversus abdominis plane block in conjunction with intrathecal morphine is the most effective strategy. In the absence of intrathecal morphine, lateral transversus abdominis plane block or local anesthetic wound infiltration should be administered.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%