Description of a novel ultrasound-guided approach for a dorsal quadratus lumborum block: a canine cadaver study

Alaman, Manuel; Bonastre, Cristina; Blás, Ignacio de; Gomez-Alvarez, Christian M.; Laborda, Alicia

doi:10.1016/j.vaa.2021.09.002

Cited by 16 publications

(42 citation statements)

References 13 publications

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“…Another study in dogs [ 8 ] administered the contrast lateral to the QL muscle, and it showed a similar distribution of the spinal nerves (from L 1 to L 3 ), but the contrast was found staining the sympathetic trunk at a much higher level (up to T 11 ). Finally, Alaman et al [ 9 ] studied the spreading, administering the contrast dorsal to the QL muscle, and they found similar results. Based on these results, it seems clear that the QLB would provide somatic analgesia for the mid-caudal abdomen, although it might provide visceral analgesia to structures in the medium part of the abdomen.…”

Section: Introductionmentioning

confidence: 80%

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Evaluation of Quadratus Lumborum Block as Part of an Opioid-Free Anaesthesia for Canine Ovariohysterectomy

Viscasillas

Sanchis‐Mora

Burillo

et al. 2021

Animals

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Quadratus lumborum block (QLB) is used to provide analgesia for abdominal surgery in humans. The aim of this study was to assess an anaesthetic protocol involving the QLB for canine ovariohysterectomy. Ten dogs were included. Anaesthetic protocol consisted of premedication with IM medetomidine (20 μg kg−1) and SC meloxicam (0.1 mg kg−1), induction with propofol to effect, and maintenance with sevoflurane in oxygen/medical air. QLB was performed injecting 0.4 mL kg−1 of 0.25% bupivacaine/iohexol per side. Computed Tomography (CT) was performed before and after surgery. Fentanyl was administered as rescue analgesia during surgery. The Short Form of The Glasgow Composite Pain Scale and thermal threshold (TT) at the level of the elbow, T10, T13 and L3 were assessed before premedication and every hour postoperatively. Methadone was given as rescue analgesia postoperatively when pain score was >3. A Yuen’s test on trimmed means for dependent samples was used to analyse the data (p < 0.05). CT images showed spreading of the contrast/block for a median (range) of 3 (2–5) vertebrae, without differences between preoperative and postoperative images. One dog needed rescue analgesia during surgery. Pain score was less than 4/24 in all the animals during the first 4 h after surgery. TT showed a significant increased signal in all the areas tested, apart from the humerus, 30 min after surgery. The QLB may provide additional analgesia for canine ovariohysterectomy. Further studies are needed to assess the specific contribution of the QLB in abdominal analgesia.

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Section: Introductionmentioning

confidence: 80%

“…Several studies have been published in veterinary medicine describing the technique in dogs [ 7 , 8 , 9 , 10 ] and cats [ 11 ] and assessing the contrast spreading in cadavers. Three studies administered the contrast between the quadratus lumborum and psoas muscles [ 7 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Quadratus Lumborum Block as Part of an Opioid-Free Anaesthesia for Canine Ovariohysterectomy

Viscasillas

Sanchis‐Mora

Burillo

et al. 2021

Animals

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“…The results obtained in this study showed that the administration of higher volumes (0.6 mL kg −1 ) of solution between the PM muscle and the vertebral body of L1 could be considered as a valid and viable technique to perform QL blocks in dogs. The point of injection employed here was situated at the dorsal and medial to the interfascial site, between the QL and PM muscles, which was proposed as an injection site by Garbin et al [ 2 ] and Viscasillas et al [ 5 ], and was more medial than the site of injection employed by Alamán et al [ 4 ]. This technique consistently stained the ventral branches of L1, L2 and L3 (100%) and the sympathetic trunk (80%).…”

Section: Discussionmentioning

confidence: 98%

“…A quadratus lumborum (QL) block is an ultrasound-guided regional anesthesia technique that targets the fascial plane of the QL muscle and could provide a sensorial blockade of multiple areas of the abdomen [ 1 ]. In recent years, some anatomical and spread studies have been published with the aim of evaluating its feasibility in dogs [ 2 , 3 , 4 , 5 ], cats [ 6 ] and goats [ 7 ]. Veterinary literature also includes a case report of a cat [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…In these studies, volumes of 0.15 to 0.3 mL kg −1 were injected per hemiabdomen. In another study, Alamán et al [ 4 ] investigated the distribution of 0.5 mL kg −1 of injectate (methylene blue) administered between the QL muscle and the vertebral body of L1. The results of these studies showed a consistent spread in the L1, L2 and L3 spinal nerves and in the sympathetic trunk, although the spreading of dye in the last thoracic nerves was limited.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of High-Volume Injections Using a Modified Dorsal Quadratus Lumborum Block Approach in Canine Cadavers

Marchina-Gonçalves

Gil

Laredo

et al. 2021

Animals

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The quadratus lumborum (QL) block targets the fascial plane surrounding the QL muscle providing abdominal somatic and visceral analgesia. The extension of its analgesic effects is a subject of research, as it could not cover areas of the cranial abdomen in dogs. This study assesses in eight thawed canine cadavers, the distribution of high-volume injections (0.6 mL kg−1 of a mixture of methylene blue and iopromide) injected between the psoas minor muscle and the vertebral body of L1. Anatomical features of the area of interest were studied in two cadavers. In another six dogs, QL blocks were performed bilaterally under ultrasound-guidance. The distribution of contrast was evaluated by computed tomography (CT). Hypaxial abdominal muscles were dissected to visualize the dye spread (spinal nerves and sympathetic trunk) in 5 cadavers. The remaining cadaver was refrozen and cross-sectioned. CT studies showed a maximum distribution of contrast from T10 to L7. The methylene blue stained T13 (10%), L1 (100%), L2 (100%), L3 (100%), L4 (60%) and the sympathetic trunk T10 (10%), T11 (20%), T12 (30%), T13 (70%), L1 (80%), L2 (80%), L3 (60%) and L4 (30%). These findings may suggest that despite the high volume of injectate administered, this modified QL block could not produce somatic analgesia of the cranial abdomen, although it could provide visceral analgesia in dogs.

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Bilateral ultrasound‐guided lateral quadratus lumborum block in a minipig undergoing ovariectomy

Klonner

Verdier

Otero

2023

Vet Record Case Reports

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A 2-year-old Göttingen miniature pig was presented for elective ovariectomy. After premedication with ketamine 15 mg/kg and azaperone 2 mg/kg intramuscularly, general anaesthesia was induced with propofol 1.5 mg/kg intravenously. With the animal in sternal recumbency, a 15 × 15 cm area on the dorsolateral aspect of the flank at the level of the second lumbar vertebra (L2) was clipped and aseptically prepared. Using a linear transducer, the epaxial musculature as well as the quadratus lumborum and abdominal wall muscles were identified. Then, 0.6 ml/kg of 0.25% ropivacaine was injected bilaterally at the level of L2 using a ventral-to-dorsal in-plane approach under ultrasound guidance. Anaesthesia was stable and uneventful. Predefined thresholds for nociception were not exceeded at any time. After recovery, regular pain evaluation using the Universidade Estadual Paulista (UNESP)-Botucatu pig composite acute pain scale did not indicate the need for rescue analgesia up to 4 h after the block was performed.

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Description of a novel ultrasound-guided approach for a dorsal quadratus lumborum block: a canine cadaver study

Cited by 16 publications

References 13 publications

Evaluation of Quadratus Lumborum Block as Part of an Opioid-Free Anaesthesia for Canine Ovariohysterectomy

Evaluation of Quadratus Lumborum Block as Part of an Opioid-Free Anaesthesia for Canine Ovariohysterectomy

Evaluation of High-Volume Injections Using a Modified Dorsal Quadratus Lumborum Block Approach in Canine Cadavers

Bilateral ultrasound‐guided lateral quadratus lumborum block in a minipig undergoing ovariectomy

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