ESRA19-0050 A subfascial local anesthetic injection to the psoas major muscle combined with the anterior approach for quadratus lumborum block: technical description and retrospective evaluation

Purpose of Review. Since the original publication on the quadratus lumborum (QL) block, the technique has evolved significantly during the last decade. This review highlights recent advances in various approaches for administering the QL block and proposes directions for future research. Recent Findings. The QL block findings continue to become clearer. We now understand that the QL block has several approach methods (anterior, lateral, posterior, and intramuscular) and the spread of local anesthetic varies with each approach. In particular, dye injected using the anterior QL block approach spread to the L1, L2, and L3 nerve roots and within psoas major and QL muscles. Summary. The QL block is an effective analgesic tool for abdominal surgery. However, the best approach is yet to be determined. Therefore, the anesthetic spread of the several QL blocks must be made clear.

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Supine coronal approach to quadratus lumborum block in combination with anterior approach Sciatic block for sole anesthesia of hip fracture surgery

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2021.110303 ◽

2021 ◽

Vol 72 ◽

pp. 110303

Author(s):

Başak Altıparmak ◽

Melike Korkmaz Toker ◽

Ali İhsan Uysal ◽

Cem Yalın Kılınç

Keyword(s):

Hip Fracture ◽

Anterior Approach ◽

Hip Fracture Surgery ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum ◽

Fracture Surgery

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Ultrasound guided catheter placement for TeQuiLa block: a novel techinique for post-operative analgesia for abdominal surgeries

Journal of Society of Anesthesiologists of Nepal ◽

10.3126/jsan.v4i2.21211 ◽

2018 ◽

Vol 4 (2) ◽

pp. 94-95

Author(s):

Prajjwal Raj Bhattarai

Keyword(s):

Abdominal Surgery ◽

Continuous Infusion ◽

Postoperative Analgesia ◽

Local Anesthetic ◽

Catheter Placement ◽

Ultrasound Guided ◽

Effective Measure ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum

Ultrasound guided abdominal plane blocks are being considered as effective measure for postoperative analgesia. Among these Quadratus Lumborum Block has been reported to provide adequate analgesia for abdominal surgeries. Placement of catheter for continuous infusion of local in these plane provide long term analgesia for abdominal surgery. More recently, a transmuscular quadratus lumborum block (TeQuiLa Block) was described by Borglum et al and we have tried to use catheter placement and local anesthetic infusion for the same.Journal of Society of Anesthesiologists of NepalVol. 4, No.2, 2017, Page: 94-95

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Sacroiliac joint arthrodesis for chronic sacroiliac joint pain: an anterior approach and clinical outcomes with a minimum 5-year follow-up

Journal of Neurosurgery Spine ◽

10.3171/2018.1.spine17115 ◽

2018 ◽

Vol 29 (3) ◽

pp. 279-285 ◽

Cited By ~ 4

Author(s):

Eiichi Murakami ◽

Daisuke Kurosawa ◽

Toshimi Aizawa

Keyword(s):

Sacroiliac Joint ◽

Anterior Approach ◽

Pelvic Ring ◽

Abdominal Muscle ◽

Bone Union ◽

Anterior Surface ◽

Cutaneous Injury ◽

Psoas Major Muscle ◽

Psoas Major

OBJECTIVEThe authors evaluated the outcomes of sacroiliac joint (SIJ) arthrodesis via an original anterior approach to the upper anterior surface of the SIJ in patients with a minimum of 5 years’ follow-up.METHODSThe authors performed anterior SIJ arthrodesis in 45 patients between 2001 and 2015. Of these patients, 27 (11 men and 16 women; mean age at surgery 49 [24–86] years) were followed up for a minimum of 5 years (average 113 months, range 61–157 months). In the 14 patients in the earlier period of this study, the authors used an anterior approach to expose the SIJ by separating the iliac muscle from the iliac bone and performed internal fixation. In the 13 patients later in the study, the authors changed to a pararectal approach, which involved an incision along the lateral border of the rectus abdominal muscle. Then, extraperitoneally, the upper anterior surface of the SIJ was exposed between the psoas major muscle and the iliac muscle.RESULTSAmong the 27 patients, 21 had unilateral anterior arthrodesis alone, 4 required additional posterior arthrodesis, and 2 required pelvic ring arthrodesis because of later pain on the opposite side. In the 21 patients with a unilateral anterior arthrodesis, outcome according to the modified Macnab criteria was excellent in 7, good in 11, and fair in 3. Outcomes were excellent, good, fair, and poor in 1 patient each among the 4 with additional posterior fusion. Outcomes were good and poor for 1 patient each among those with pelvic ring arthrodesis. All 27 patients demonstrated bone union of the SIJ on CT. Lateral femoral cutaneous neuralgia developed in 7 of the 27 patients; 6 patients had undergone the initial anterior method and 1 the later method.CONCLUSIONSAnterior SIJ arthrodesis was effective in most patients with severe SIJ pain resistant to conservative therapy. This approach has the advantage of direct curettage and bone graft into the wide area of the SIJ, which result in good bone union. In particular, the authors’ current pararectal approach could decrease the potential risk of lateral cutaneous injury.

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PATIENT-CENTERED ANALGESIA OF THE ANTERIOR ABDOMINAL WALL IN CHILDREN OF DIFFERENT AGES: OWN EXPERIENCE

Pain anesthesia and intensive care ◽

10.25284/2519-2078.4(97).2021.248396 ◽

2021 ◽

pp. 41-46

Author(s):

Y.V. SEMKOVYCH ◽

D.V DMYTRIIEV ◽

Y.O. GLAZOV

Keyword(s):

Regional Anesthesia ◽

Single Injection ◽

Transversalis Fascia ◽

Opioid Use ◽

Patient Centered ◽

Early Recovery ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum ◽

Perioperative Pain Management ◽

Psoas Major

Introduction. Regional anesthesia in pediatric practice is one of the most valuable and safest tools for perioperative pain management. The advantages of regional anesthesia are early recovery of children, reducing opioid consumption, postoperative pain, respiratory complications, nausea, vomiting, as well as health care costs. The aim of the study was to analyze the data on the effect of the quadratus lumborum block and the transversalis fascia block on the duration and effectiveness of postoperative analgesia and propose a model of combining two blocks with a single injection. Materials and methods. Today there is growing interest in the use of new methods of regional anesthesia, especially the anterior and posterior torso blocks. The quadratus lumborum block and the transversalis fascia block are aimed at providing analgesia over the T7-L1 dermatomes, namely the ilio-inguinal and iliac nerves, which extend from the lateral portion of the psoas major, the lower edge of the 12th rib; however, there is evidence of cranial spread to the T4 – T5 dermatomes, and caudal spread to the L2 – L3 dermatomes. Currently, there are enough publications concerning the quadratus lumborum block and the transversalis fascia block. Results. For adequate perioperative multimodal anesthesia, the authors proposed a combination of the transversalis fascia block and the quadratus lumborum block with a single injection and ultrasound guidance. Conclusions. The advantages of the proposed method include simplicity, less invasiveness, adequate analgesia during surgery, as well as during the postoperative period (exclusion of somatic and visceral components), as evidenced by the assessment on a visual analogue scale (no more than two points). In addition, it significantly reduces the perioperative opioid use.

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