Ultrasound-guided quadratus lumborum plane block for congenital hip dislocation surgery: Dermatomes and osteotomes

İnce, İlker; Hamadnalla, Hassan; Hassan, Mohd Hasyizan; Qiu, Yuwei

doi:10.1016/j.jclinane.2018.10.044

Cited by 3 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The QL blocks have been reported for the postoperative analgesia for laparoscopic nephrectomy and other abdominal or hip surgery. 2,[25][26][27][28][29][30][31] There are several approaches to QL blocks with different characteristics. 4,17,[32][33][34][35] The subcostal approach allows the LA to inject into the compartment between the QL muscle and transversalis fascia, while the transmuscular approach targets the LA into the compartment between the QL and psoas major muscle.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Sensory Loss and Postoperative Analgesia Obtained by Diaphragmatic Apposition Zone Block Under Direct Laparoscopic Visualization in Patients Undergoing Nephrectomy: A Descriptive Study

Shi¹,

Wang²,

Yang³

et al. 2022

JPR

View full text Add to dashboard Cite

Purpose Local anesthetics can spread into the subendothoracic fascia compartment via the arcuate ligament and apposition zone of the diaphragm after the anterior quadratus lumborum blocks. Therefore, a new block may be achieved if local anesthetic is administered into the diaphragmatic apposition zone (DAZ) under direct laparoscopic visualization by surgeons. Therefore, we evaluated the sensory loss and postoperative analgesic efficacy of this new block in patients receiving laparoscopic nephrectomy. Methods A total of 28 patients scheduled to receive elective laparoscopic nephrectomy under general anesthesia were enrolled in this study. The DAZ blocks were performed in patients under direct laparoscopic visualization with 20 mL of 0.5% ropivacaine before the dissected kidneys or renal tumors were taken out from the incision. All patients received the intravenous patient-controlled analgesia after surgery. The dermatomes of sensory loss and the muscle weakness of quadriceps femoris were assessed at 2 h post-surgery in the wards. The postoperative pain was scored. The opioid consumption in the first 24 h after surgery was recorded. Results The average number of dermatomes of sensory block was 8.6 ± 1.2. The highest level of sensory loss was T6 (T5-T6) [median (interquartile range, IQR)], and the lowest level of sensory block was L1 (L1–L2). The postoperative pain scores at rest or on movement at 2 h, 6 h, 12 h, 24 h and 48 h were kept at the low levels (less than 4). The muscle strength of the quadriceps femoris evaluated was 5 (5–5) points [median (IQR)]. Total dose of intravenous morphine equivalent consumption in the first 24 h after surgery was 21.2 ± 4.1 mg. Conclusion The DAZ block manifests a wide dermatomal coverage of sensory loss and is associated with the low levels of postoperative pain intensity and opioid use. It provides a new postoperative analgesia option for patients undergoing laparoscopic nephrectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of Sensory Loss and Postoperative Analgesia Obtained by Diaphragmatic Apposition Zone Block Under Direct Laparoscopic Visualization in Patients Undergoing Nephrectomy: A Descriptive Study

Shi¹,

Wang²,

Yang³

et al. 2022

JPR

View full text Add to dashboard Cite

show abstract

“…However, Ince et al stated that the innervation of the bones has its own pattern and that does not directly correlate to the innervation of more superficial structures such as muscle and skin and raised a question how does QLB provide postoperative analgesia in hip surgery cases with pelvic osteotomies as Ashikliogul et al report on. They also highlight that some nerve branches responsible for innervation of the hip joint arise from levels which are not affected by QLB ( 39 ). Another issue that arises is the volume of local anesthetic used for achieving proper analgesia.…”

Section: Critical Evaluation Of Quadratus Lumborum Blockmentioning

confidence: 99%

Applications and Critical Evaluation of Fascia Iliaca Compartment Block and Quadratus Lumborum Block for Orthopedic Procedures

Plečko

Bohaček

Tripković

et al. 2019

ACC

View full text Add to dashboard Cite

Anterior section of the hip joint capsule is innervated by femoral nerve and obturator nerve, and posterior section is innervated by the nerve to quadratus femoris muscle and occasionally by the superior gluteal (posterolateral region) and sciatic nerve (posterosuperior region). one of the regional anesthesia options for hip surgery is the fascia iliaca compartment block (fiCb) that affects nerves important for hip innervation and sensory innervation of the thigh -femoral, obturator and lateral femoral cutaneous nerve. fiCb can be easily performed and is often a good solution for management of hip fractures in emergency departments. its use reduces morphine pre-operative requirement for patients with femoral neck fractures and can also be indicated for hip arthroplasty, hip arthroscopy and burn management of the region. quadratus lumborum block (qlb) is a block of the posterior abdominal wall performed exclusively under ultrasound guidance, with still unclarified mechanism of action. When considering hip surgery and postoperative management, the anterior qlb has shown to reduce lengthy hospital stay and opioid use, it improves perioperative analgesia in patients undergoing hip and proximal femoral surgery compared to standard intravenous analgesia regimen, provides early and rapid pain relief and allows early ambulation, thus preventing deep vein thrombosis and thromboembolic complications etc. however, some nerve branches responsible for innervation of the hip joint are not affected by qlb, which has to be taken into consideration. qlb has shown potential for use in hip surgery and perioperative pain management, but still needs to be validated as a reliable treatment approach. keywords: hip joint innervation; regional anesthesia; orthopedic surgery; fascia iliaca compartment block; quadratus lumborum block

show abstract

“…In order to better understand the development of the hip joint in babies, Dahlstrom et al (8) , used a variety of ultrasonic techniques. Graf (9) set the gold standard for ultrasonography of the hip in infants (10) .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Developmental Dysplastic Hip in Zagazig University Hospitals; Ultra-Sound Study

Fawal

Mohamed

Tantawy

et al. 2022

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: Developmental Dysplastic Hip (DDH) is common impaired development in newborns. Ultrasound (US) is the gold standard for assessing hip development in infants younger than six months. Objective: This study aimed to detect diagnostic accuracy of ultrasound examination for hip joint in neonates and to detect possible risk factors related with prevalence of DDH. Patients and methods: A total of 525 infants were referred to the Radiology Section at Zagazig University Hospitals after showing indicators of hip instability during their neonatal examinations. They were included in this cross-sectional trial. All patients were subjected to thorough history and clinical evaluation as well as US modality. Results: Of the 5,360 hip joints analyzed, 89.57% were categorized as type Ia or Ib by Graf, 10.19% as type IIa, and 0.24% as types IIc to IV. There was significant differences between clinical and sonographic assessments. A greater birth weight was found to have a negative impact on the α-angles in univariate regression analysis, as was a later delivery (by weeks) beyond the due date. Birth weight, female gender, and a family history of DDH were found to significantly affect α-angles-angles by multiple regression analysis (p<0.0001, p<0.0001, p=0.005 successively). Conclusion: There were significant differences between clinical and sonographic assessments. We also detected some possible risk factors related with prevalence of DDH. In comparison to 2D ultrasound, DDH detection with 3D ultrasound took less time and had higher inter-rater reliability.

show abstract

Ultrasound-guided quadratus lumborum plane block for congenital hip dislocation surgery: Dermatomes and osteotomes

Cited by 3 publications

References 4 publications

Evaluation of Sensory Loss and Postoperative Analgesia Obtained by Diaphragmatic Apposition Zone Block Under Direct Laparoscopic Visualization in Patients Undergoing Nephrectomy: A Descriptive Study

Evaluation of Sensory Loss and Postoperative Analgesia Obtained by Diaphragmatic Apposition Zone Block Under Direct Laparoscopic Visualization in Patients Undergoing Nephrectomy: A Descriptive Study

Applications and Critical Evaluation of Fascia Iliaca Compartment Block and Quadratus Lumborum Block for Orthopedic Procedures

Prevalence of Developmental Dysplastic Hip in Zagazig University Hospitals; Ultra-Sound Study

Contact Info

Product

Resources

About