The efficacy of ultrasound-guided anterior quadratus lumborum block for pain management following lumbar spinal surgery: a randomized controlled trial

Abstract

Background Quadratus lumborum block (QLB) is a fascial plane block. There is no randomized study on the efficacy of QLB for lumbar surgery. We evaluated the efficacy of QLB for postoperative pain management and patient satisfaction after lumbar disc herniation surgery (LDHS). Methods Sixty patients with ASA score I-II planned for LDHS under general anesthesia were included. We allocated the patients into two groups: the QLB group (n = 30) or the control group (n = 30). QLB was performed with 30 ml 0.25% bupivacaine in the QLB group. Paracetamol 1 g IV 3 × 1 was ordered to the patients at the postoperative period. If the NRS score was ≥ 4, 1 mg/ kg tramadol IV was administered as rescue analgesia. Results There was a reduction in the median static NRS at 0 h and 2 h with QLB compared to the control group (p < 0.05). There was no difference in the resting NRS at any other time point up to 24 h. The median dynamic NRS was significantly lower at 0, 2, 4, 8, and 16 h in the QLB group (p < 0.05). The need for rescue analgesia was significantly lower in the QLB group. The incidence of nausea was significantly higher in the control group. The postoperative patient satisfaction was significantly higher in the QLB group (p < 0.05). Conclusion We found that the QLB is effective for pain control following LDHS.

Comparison of Two Different Positions for Ultrasound-Guided Intervertebral Distance Evaluation

“…After the USG evaluation was completed, participants were asked to rate their position experience using a 7-point Likert numerical comfort assessment questionnaire. 10 The stretcher comfort, position comfort, waist comfort, and abdominal comfort were scored as 1 (very bad) - 7 (perfect) for both positions.…”

Hérnia Inguinal: Abordagem Médica No Reparo Cirúrgico

“…Ademais, alguns homens estão mais expostos a atividades que aumentam o risco de hérnias inguinais, como levantar objetos pesados regularmente no trabalho ou praticar esportes que envolvem movimentos bruscos e esforços intensos. Esses fatores combinados contribuem para a maior prevalência de hérnias inguinais em homens, destacando a importância da conscientização sobre os fatores de risco e medidas preventivas 1,9 .…”

“…Após a reparação, a incisão é fechada com suturas e o paciente é monitorado durante o período de recuperação. A cirurgia geralmente é realizada em regime de ambulatório, o que significa que o paciente pode retornar para casa no mesmo dia, embora o tempo de recuperação possa variar dependendo da extensão da cirurgia e da saúde geral do paciente 1,5 .…”

“…Dessa forma, o objetivo desse estudo foi investigar a eficácia e segurança das diferentes abordagens médicas no reparo cirúrgico da hérnia inguinal, com foco na redução da taxa de recorrência, complicações pós-operatórias e tempo de recuperação, visando fornecer diretrizes para a prática clínica baseadas em evidências 1,4,5 .…”

Ultrasound-guided quadratus lumborum block: a powerful way for reducing postoperative pain

“…Regrettably, both of these studies have since been withdrawn. In a more recent study examining the impact of QLB on postoperative pain management following lumbar disc herniation surgery, it was found that administering QLB after the surgery enhanced the patient’s comfort levels both during periods of rest (0 and 2 h postoperatively) and activity (0, 2, 4, 8, and 16 h postoperatively) 51 . Wilton et al 52 .…”