Ultrasound-guided transmuscular quadratus lumborum block for perioperative analgesia in open nephrectomy

Corso, Ruggero M; Piraccini, Emanuele; Sorbello, Massimiliano; Bellantonio, Daniele; Tedesco, Mario

doi:10.23736/s0375-9393.17.12167-x

Cited by 31 publications

(13 citation statements)

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“…In our study, higher volume regimes increased the range of our blocks and reached a higher thoracic dermatomal distribution. Clinically, we chose different injection levels (L1–2, L3, L4) of QLB for different kinds of surgery (e.g., nephrectomy [ 17 ], cesarean delivery [ 18 ], hip arthroplasty [ 19 ]) to ease the spread of local anesthetic for fulfilling the requirement of local analgesia. Our study shows that different volumes can be used at one injection level at L2 to acquire a different block area for different clinical applications.…”

Section: Discussionmentioning

confidence: 99%

Anterior Quadratus Lumborum block area comparison in the three different volumes of Ropivacaine: a double-blind, randomized controlled trial in healthy volunteers

Shao

Luo

et al. 2022

BMC Anesthesiol

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Background In abdominal surgery, ultrasound-guided anterior quadratus lumborum blocks (QLB) are performed to induce analgesia. However, no study reported suitable volumes of the anterior QLB for the different postoperative analgesia regions. Therefore, this prospective randomized controlled study assessed the dermatomal spread and analgesic effects of the three different volumes of a local anesthetic for anterior QLB. Methods Ultrasound-guided anterior QLB was performed at the L2 level on 30 healthy volunteers. The volunteers were randomized to receive 20 ml (n = 10), 30 ml (n = 10), and 40 mL (n = 10) of 0.375% ropivacaine. The cutaneous sensory blocked area (CSBA), the number of block dermatomes, and the block duration time were measured by determining the extent of the cold sensation. Results The CSBA was significantly larger in the 40 ml group than in the 30 (P = 0.001; 1350.6 ± 234.4 vs. 1009.5 ± 151.6 cm2) and 20 ml groups (P < 0.001; 1350.6 ± 234.4 vs. 808.1 ± 120.5 cm2). Similarly, the number of blocked dermatomes was significantly higher in the 40 ml group than in the 30- and 20-ml groups. However, no significant difference was observed in block duration among the groups. Conclusions No difference was observed in block duration with the various volumes of 0.375% ropivacaine. However, the larger volume for anterior QLB contributed to a larger area of cutaneous sensory blockade. Appropriate volumes in anterior QLB can create suitable postoperative analgesia levels for the different operative sites. Trial registration The study was registered in the Chinese Clinical Trial Registration Center on www.chictr.org.cn on 27th April 2018 (registration number: ChiCTR-IOR-17010853).

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Section: Discussionmentioning

confidence: 99%

Anterior Quadratus Lumborum block area comparison in the three different volumes of Ropivacaine: a double-blind, randomized controlled trial in healthy volunteers

Shao

Luo

et al. 2022

BMC Anesthesiol

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“…In our study, higher volume regimes increased the range of our blocks and reached a higher thoracic dermatomal distribution. Clinically, we chose different injection levels (L1-2, L3, L4) of QLB for different kinds of surgery (e.g., nephrectomy 17 , cesarean delivery 18 , hip arthroplasty 19 ) to ease the spread of local anesthetic for ful lling the requirement of local analgesia. Our study shows that at one injection level at L2, different volumes can be used to acquire a different block area for different clinical applications.…”

Section: Discussionmentioning

confidence: 99%

Anterior Quadratus Lumborum Block Area Comparison in the Three Different Volumes of Ropivacaine: A Double-blind, Randomized Controlled Trial in Healthy Volunteers

Shao

Luo

et al. 2022

Preprint

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Background In abdominal surgery, ultrasound-guided anterior quadratus lumborum blocks (QLB) are performed for inducing analgesia. However, no study reported the suitable volumes of the anterior QLB for the different postoperative analgesia regions. This prospective randomized controlled study assessed the dermatomal spread and analgesic effects of the three different volumes of a local anesthetic for anterior QLB. Methods Ultrasound-guided anterior QLB was performed at the L2 level on 30 healthy volunteers. The participants were randomized to receive 20 ml (n = 10), 30 ml (n = 10) and 40 mL (n = 10) of 0.375% ropivacaine. The cutaneous sensory blocked area (CSBA), the number of block dermatomes, and the block duration time were measured by determining the extent of the cold sensation. Results The CSBA was significantly larger in the 40 ml group than the 30 (P = 0.001; 1350.6 ± 234.4 vs 1009.5 ± 151.6 cm2) and 20 ml groups (P < 0.001; 1350.6 ± 234.4 vs 808.1 ± 120.5 cm2). Similarly, the number of blocked dermatomes was significantly higher in the 40 ml group than in the 30 and 20 ml groups. No significant difference was observed in block duration among the groups. Conclusions No difference was observed in block duration with the various volumes of 0.375% ropivacaine. However, the larger volume for anterior QLB contributed to a larger area of cutaneous sensory blockade. Appropriate volumes in anterior QLB can create suitable postoperative analgesia levels for the different operative sites. Trials Registration: The study was registered in the Chinese Clinical Trial Registration Center on www.chictr.org.cn on 27 April 2018 (registration number: ChiCTR-IOR-17010853).

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“…Transmuscular QLB and anterior subcostal QLB have been recently created to reduce pain during retroperitoneal and intraperitoneal surgical operations. The method of action depends on local anaesthetic spreading cranially in the direction of the thoracic paravertebral space by different level of dermatomal distribution [7].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Transmuscular and Thoracic Paravertebral Block Effective for Acute Postoperative Pain Management in Open Renal Surgeries

Aboharga

Elashry

Salama

et al. 2023

JAMMR

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Background: Systemic analgesics should be used carefully when treating patients following renal surgery since these patients often have compromised renal function. Therefore, in such individuals, the localized nerve block may be a useful choice. This study's objective was to assess the effectiveness of transmuscular and anterior subcostal QLBs as a secure substitute for thoracic paravertebral blocks guided by ultrasonography for treating immediate postoperative pain in patients having open kidney operations. Methods: This prospective randomized double blinded study was carried out on 54 adult patients who underwent elective open renal surgeries. Patients were randomly classified into three equal groups, all were guided by ultrasonography: Group I: Transmuscular QLB, group II: Anterior Subcostal Quadratus Lumborum (ASQL) Block, and group III: Thoracic Paravertebral (TPV) Block. Results: Regarding the beginning of sensory block, overall intraoperative fentanyl usage, period to first rescue analgesic demand, and overall morphine consumption, there was a substantially significant difference between the three groups (P-value <0.001). VAS revealed a substantial difference between the three groups (P<0.001) at T0 before discharging from PACU, 2, 4 and 6 hours. There was statistically significant increase in patients’ satisfaction in group II&III compared to group I where (P =0.03). Conclusions: Ultrasound-guided anterior subcostal QLB produced safe and adequate analgesia during and after open renal surgeries that was comparable to thoracic paravertebral block, but the transmuscular QLB failed to provide adequate analgesia compared to anterior subcostal QLB and thoracic paravertebral block.

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Ultrasound-guided transmuscular quadratus lumborum block for perioperative analgesia in open nephrectomy

Cited by 31 publications

References 0 publications

Anterior Quadratus Lumborum block area comparison in the three different volumes of Ropivacaine: a double-blind, randomized controlled trial in healthy volunteers

Anterior Quadratus Lumborum block area comparison in the three different volumes of Ropivacaine: a double-blind, randomized controlled trial in healthy volunteers

Anterior Quadratus Lumborum Block Area Comparison in the Three Different Volumes of Ropivacaine: A Double-blind, Randomized Controlled Trial in Healthy Volunteers

Ultrasound-Guided Transmuscular and Thoracic Paravertebral Block Effective for Acute Postoperative Pain Management in Open Renal Surgeries

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