[The supine coronal midaxillary approach to anterior quadratus lumborum block: case report].

Abstract:

BACKGROUND:There are various approaches to perform an ultrasound guided Quadratus Lumborum Block (QLB). The lateral, posterior, anterior or trans muscular and subcostal paramedian are the various approaches described for performing a QLB. Each of these blocks are aimed to achieve a maximum spread with high volume and low concentration of local anesthetics. CASE REPORT:In this novel approach a curvilinear ultrasound probe was used with the patient lying in supine position. The probe was placed longitudinally in the mid axillary line to visualize Quadratus Lumborum Muscle (QLM) in the coronal plane. The needle was then introduced from cranial to caudal direction and catheters were inserted in the Anterior Thoracolumbar Fascia (ATLF) up to a distance of 4-5 cm in 24 patients for an anterior approach to acetabulum fractures. The needle tip and the Local Anesthetic (LA) spread was visible in all patients. All patients except 4 had excellent perioperative pain relief considering stable hemodynamics and VAS 2-3/10 for the first 48 hours. All patients received 1g intravenous paracetamol each 8hours. VAS in postoperative period was 2-3/10, in 20/24 patients. In the postoperative period, 4 patients complained of persistent pain, requiring intravenous fentanyl boluses and multimodal analgesia. Mean VAS score was 2.87 from 0-12 hours, 3.14 from 12-24 hours, and 3.35 from 24-48 hours. There were no block-related complications in any patient. CONCLUSION:The supine midaxillary coronal approach to anterior QLB is an effective and feasible approach to QLB which can be performed in supine position.

journal_name

Rev Bras Anestesiol

authors

Diwan S,Blanco R,Kulkarni M,Patil A,Nair A

doi

10.1016/j.bjan.2020.04.007

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

443-447

issue

4

eissn

0034-7094

issn

1806-907X

pii

S0034-7094(20)30354-8

journal_volume

70

pub_type

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  • Use of volatile anesthetics in extracorporeal circulation.

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  • [Ultrasound-guided costoclavicular block as an alternative for upper limb anesthesia in obese patients].

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  • [Evaluation of pulmonary function in patients undergoing cardiac surgery with cardiopulmonary bypass.].

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  • [Implementation of a Preanesthetic Evaluation Service in a University Hospital: difficulties and results.].

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    journal_title:Revista brasileira de anestesiologia

    pub_type: 杂志文章

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  • [Theoretical basis for the implementation of problem-oriented learning in anesthesiology residency programs.].

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    pub_type: 杂志文章

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    更新日期:2003-04-01 00:00:00

  • [Remifentanil: does the infusion regimen make a difference in the prevention of hemodynamic responses to tracheal intubation?].

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    journal_title:Revista brasileira de anestesiologia

    pub_type: 杂志文章

    doi:10.1590/s0034-70942007000300003

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    更新日期:2007-06-01 00:00:00

  • Anesthesia for Blalock-Taussig shunt and pacemaker placement in an adult patient with univentricular heart. Case report.

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    journal_title:Revista brasileira de anestesiologia

    pub_type: 杂志文章

    doi:10.1590/s0034-70942008000300007

    authors: Lorentz MN,Soares RR,Ribeiro CV,Valadares FW

    更新日期:2008-05-01 00:00:00