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

Author(s):  
Y.V. SEMKOVYCH ◽  
D.V DMYTRIIEV ◽  
Y.O. GLAZOV

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.

2021 ◽  
pp. rapm-2021-102598
Author(s):  
Mette Dam ◽  
Christian Hansen ◽  
Troels Dirch Poulsen ◽  
Nessn Htum Azawi ◽  
Jens Børglum

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092099
Author(s):  
Liangjing Yuan ◽  
Ye Zhang ◽  
Chengshi Xu ◽  
Anshi Wu

Objective To investigate the postoperative analgesic effect of ultrasound-guided quadratus lumborum block (QLB) in patients undergoing arthroscopic hip surgery. Methods Patients who were scheduled to undergo elective arthroscopic hip surgery were randomly assigned to the QLB (Q) or control (C) group (n = 40 each). After general anesthesia induction, unilateral QLB was performed under ultrasound guidance in the Q group. The amount of opioid use via patient-controlled analgesia (PCA) and the resting and movement pain visual analog scale (VAS) scores when the patient left the postanesthesia care unit (PACU) and 4, 8, 12, and 24 hours after surgery were recorded. Postoperative complications were recorded for both groups. Results At 24 hours post-surgery, opioid consumption amounts via PCA (48.4 [48.1–48.6] mL) in the Q group were significantly lower compared with the C group (52.0 [51.0–53.8] mL). A significant reduction in opioid consumption was observed between the two groups at each time point. Resting and movement VAS scores at each time point were significantly lower in the Q compared with the C group. Conclusions Hip arthroscopy patients who received QLB and general anesthesia in combination had less pain and a lower opioid requirement within 24 hours postoperatively.


2021 ◽  
pp. 34-34
Author(s):  
Nada Pejcic ◽  
Radomir Mitic ◽  
Ivana Nikolic ◽  
Neeti Sadana ◽  
Ivan Velickovic

Introduction. The quadratus lumborum block (QLB) was the first interfascial plane block introduced in Leskovac General Hospital thanks to the international teaching Kybele Inc. program in April 2017. Outline of cases. During the period from April 2017 to December 2019, 22 pediatric patients underwent various surgical procedures and had the QLB type 1 block as a part of a multimodal perioperative pain management plan. Unilateral QLB was provided for unilateral inguinal hernia repair, orchidopexy, testicular torsion repair, and open appendectomy. Bilateral QLB was provided for laparoscopic appendectomy and cholecystectomy. Decreased use of fentanyl and sevoflurane was noticed in the cases when QLB was performed preoperatively. All patients had well-controlled pain. Conclusion. QLB is a simple and safe technique. Clear sonographic landmarks allow it to be easily performed. QLB has great potential to improve and facilitate postoperative pain management.


2021 ◽  
Vol 34 (2) ◽  
pp. 201-209
Author(s):  
Ahmed Zaghloul Fouad ◽  
Iman Riad M. Abdel-Aal ◽  
Mohamed Rabie Mohamed Ali Gadelrab ◽  
Hany Mohammed El-Hadi Shoukat Mohammed

2019 ◽  
Vol 34 (9) ◽  
pp. 4157-4165 ◽  
Author(s):  
Mélissa Boulianne ◽  
Pamela Paquet ◽  
Raymond Veilleux ◽  
Sébastien Drolet ◽  
Alexandre Meunier ◽  
...  

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