Quadratus Lumborum Block for both cholecystectomy and right sided nephrectomy

Abstract

The quadratus lumborum block (QLB) is a unilateral facial plane block, which extends from T4 to L1 at the paravertebral space. Injecting local anesthetic between the facial plane of the quadratus lumborum muscle and the psoas major muscle provides the block of the referred dermatomes. However, the number of published studies for QLB used in various surgical procedures is limited. In this case report, we share the results of a 46-years-old ASA I female patient, who underwent open surgery for cholecystectomy and right-sided nephrectomy in the same session. After general anesthesia was induced, QLB was performed in the left lateral decubitus position. A convex probe was placed in transversely between the iliac crest and the costal margin at the midclavicular line. 20cc of 0.25% bupivacaine was injected to the facial plane between the quadratus lumborum and psoas major muscles. The surgery lasted 4 hours and completed uneventfully. In the postoperative period, the patient was provided with morphine PCA. After 24 hours, the VAS score was 0, and the total demanded morphine dose was 13 mg. This case report recommends that QLB may be an adequate choice in the postoperative pain management for patients undergoing cholecystectomy and nephrectomy.

Ultrasound-guided quadratus lumborum block for perioperative analgesia in robot-assisted partial nephrectomy: a randomized controlled trial

“…The ultrasound-guided QLB technique was first described by Blanco [11,12], and the benefits of QLB for postoperative pain relief and an opioid-sparing effect have been reported by several randomized controlled trials and case reports [2,5,6,[8][9][10][19][20][21][22][23][24][25][26][27][28][29][30]. All approaches have proven the synergistic efficacy for multimodal analgesia, especially for QLB2 or QLB3 after laparoscopic surgery, cesarean section, and total hip arthroplasty.…”

“…The quadratus lumborum block (QLB) was first described by Blanco in 2007, and later was subdivided into three basic approaches known as QLB1, 2, and 3, as well as a modified approach called intramuscular QLB, each based on needle tip position and the spread of local anesthetic (LA) [1]. Recently, numerous case reports and randomized trials have shown that QLB may be effective in relieving postoperative pain and providing an opioidsparing effect after various surgical procedures [2][3][4][5][6][7][8][9][10].…”

Quadratus Lumborum Blocks in Nephrectomy: A Narrative Review

“…33 The case reports and series reviewed in this paper uniformly reported excellent analgesic control following quadratus lumborum block for a Local and Regional Anesthesia 2021:14 variety of different nephrectomy types. [34][35][36][37][38][39][40][41] These case studies can be seen in more detail in Table 4. Like with opioid reduction, the randomized controlled trials along with observational studies show the quadratus lumborum blocks are successful in controlling postoperative pain in patients receiving laparoscopic nephrectomy.…”

Ultrasound-guided Quadratus Lumborum Block for Perioperative Analgesia in Robot-assisted Partial Nephrectomy: A Randomized Controlled Trial

“…Ultrasound-guided QLB technique was first described by Blanco [11,12], and the benefits of QLB for postoperative pain relief and opioids-sparing effect have been reported by several randomized controlled trials and case reports [2,5,6,[8][9][10][19][20][21][22][23][24][25][26][27][28][29][30]. All approaches have been proved the synergistic efficacy for multimode analgesia, especially for QLB2 or QLB3 after laparoscopic surgery, cesarean section and total hip arthroplasty.…”

“…The quadratus lumborum block (QLB) was first described by Blanco in 2007, which later can be subdivided into three basic approaches, known as QLB1, 2, 3 and a modified approach, called intramuscular QLB, based on needle tip position and the spread of local anesthetic (LA) [1]. Recently, an increasing case reports and randomized trials have show that QLB may be effective in postoperative pain relief and opioids-sparing effect after various surgery operations [2][3][4][5][6][7][8][9][10].…”