Transmuscular quadratus lumborum block (QLB) in supine position for abdominal surgeries: Pros and cons

D’souza, Nita; Himashweta, G; Diwan, Sandeep

doi:10.4103/sja.sja_505_22

Saudi J Anaesth

2023

DOI: 10.4103/sja.sja_505_22

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Transmuscular quadratus lumborum block (QLB) in supine position for abdominal surgeries: Pros and cons

Nita D’souza

G Himashweta

Sandeep Diwan

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2024

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“…For example, patients need to turn over twice or directly lie in the prone position during bilateral block, which causes pain, and inconvenience, with added risk to patients and anesthesiologists. Performing the QLB in the supine position avoids these shortcomings and improves patient compliance.In a letter to the editor: D’Souza et al successfully administered anterior QLB in the supine position in over 70 cases of various abdominal surgeries such as laparoscopic ventral hernia repair, lower segment cesarean sections, laparoscopic hysterectomies, renal transplants, laparotomies, and gall bladder surgeries 7 . In addition US-QLB has been applied with OFA in the elderly 8 .…”

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confidence: 99%

Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial

Dai,

Li,

Weng

et al. 2024

Sci Rep

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In the past, quadratus lumborum block (QLB) was mostly used for postoperative analgesia in patients, and few anesthesiologists applied it during surgery with opioid-free anesthesia (OFA). Consequently, it is still unclear whether QLB in the supine position can provide perfect analgesia and inhibit anesthetic stress during surgery under the OFA strategy. To observe the clinical efficacy of ultrasound-guided quadratus lumborum block (US-QLB) in the supine position with OFA for lower abdominal and pelvic surgery. A total of 122 patients who underwent lower abdominal or pelvic surgery in People’s Hospital of Wanning between March 2021 and July 2022 were selected and divided into a quadratus lumborum block group (Q) (n = 62) and control group (C) (n = 60) according to the random number table method. Both groups underwent general anesthesia combined with QLB in the supine position. After sedation, unilateral or bilateral QLB was performed via the ultrasound guided anterior approach based on images resembling a “human eye” and “baby in a cradle” under local anesthesia according to the needs of the operative field. In group Q, 20 ml of 0.50% lidocaine and 0.20% ropivacaine diluted in normal saline (NS) were injected into each side. In group C, 20 ml of NS was injected into each side. The values of BP, HR, SPO2, SE, RE, SPI, NRS, Steward score, dosage of propofol, dexmedetomidine, and rocuronium, the number of patients who needed remifentanil, propofol, or diltiazem, puncture point, block plane, duration of anesthesia, catheter extraction, and wakefulness during the operation were monitored. There were no significant differences in the general data, number of cases requiring additional remifentanil, propofol, or diltiazem treatment, as well as puncture point and puncture plane between the two groups (P > 0.05). HR, SBP, and DBP values were higher in group Q than in group C at T1; HR, SPI, and SE, while RE values were lower in group Q than in group C at T3, SE, and RE; the Steward score was higher in group Q than in group C at T4 and T5, and the difference was statistically significant (P < 0.05). The extubation and awake times were lower in group Q than in group C, and the difference was statistically significant (P < 0.05). The SE, RE, and SPI values were lower at T1, T2, T3, and T4 than at T0. The Steward scores at T4 and T5 were higher in group Q than in group C, and were lower than at T0, with a statistically significant difference (P < 0.05). There were significant differences in the effectiveness of postoperative analgesia between the two groups at t1, t3 and t4 (P < 0.05). US-QLB in the supine position with OFA is effective in patients undergoing lower abdominal or pelvic surgery with stable intraoperative vital signs, complete recovery and better postoperative analgesia.

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confidence: 99%

Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial

Dai,

Li,

Weng

et al. 2024

Sci Rep

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Transmuscular quadratus lumborum block (QLB) in supine position for abdominal surgeries: Pros and cons

Cited by 1 publication

References 5 publications

Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial

Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial

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