Ultrasound-Guided Continuous Quadratus Lumborum Block for Postoperative Analgesia in a Pediatric Patient

Abstract

Quadratus lumborum block is a recently introduced variation of transversus abdominis plane block. In this report, we describe the use of ultrasound-guided continuous quadratus lumborum block for postoperative analgesia in a 7-year-old child scheduled to undergo radical nephrectomy (left-sided) for Wilms tumor. The result was excellent postoperative analgesia and minimal requirement for rescue analgesics. The modification described may allow easier placement of a catheter for continuous infusion of local anesthetic.

Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Postoperative Pain After Cesarean Delivery

“…4 In the past few years, several case reports have shown that the QLB has also been successful in providing postoperative pain relief. [5][6][7][8] In a previous randomized control study, we compared the QLB against a control group, in which we intentionally moved our point of injection from the original anterolateral side of the quadratus lumborum muscle to the posterior wall (QLB type 2). 9 This has become our standard practice, as we have abandoned the anterolateral approach completely subsequent to publication of our magnetic resonance study on optimal point of insertion and dispersion of local anesthetics.…”

Essentials of Our Current Understanding

“…Injection here should result in visible spread along the anterior (ventral) surface of QLM, and some authors have described modifications that deliberately advance the needle tip into this location. 39,200 In contrast, the QL2 block is an injection on the posterior (dorsal) surface of QLM, in the plane between QL and the investing layer of thoracolumbar fascia that separates it from the overlying latissimus dorsi or paraspinal muscles (Fig. 11).…”

Postoperative Analgesia by Transmuscular Quadratus Lumborum Block Catheters

“…Ultrasound guided Quadratus lumborum block (QLB) block is a new technique of regional analgesia [3,4]. There have been reports of excellent post-operative pain management with the QLB for both abdominal and retroperitoneal surgery [5,6]. However, postoperative analgesia by bilateral transmuscular quadratus lumborum blocks (TQLB) or QL-3 block with catheter is rarely reported.…”