Obstretic Fellows, Drs. Ilana Sebbag and Fatemah Qasem, and Dr. Shalini Dhir publish case series on ultrasound guided quadratus lumborum blocks

Brazilian Journal of Anesthesiology. Available online 21 April, 2016. 

Ultrasound guided Quadratus Lumborum block for analgesia after cesarean delivery: case series

Sebbag I, Qasem F, Dhir S


INTRODUCTION: The majority of women having planned cesarean section receive spinal anesthesia for the procedure. Typically, spinal opioids are administered during the same time as a component of multimodal analgesia to provide pain relief in the 16–24 h period postoperatively. The Quadratus Lumborum block is a regional analgesic technique that blocks T5-L1 nerve branches and has an evolving role in postoperative analgesia for lower abdominal surgeries and may be a potential alternative to spinal opioids. If found effective, it will have the advantage of a reduction in opioid associated adverse effects while providing similar quality of analgesia.

METHODS: We performed bilateral Quadratus Lumborum block in 3 women who received a spinal anesthetic for a cesarean delivery and evaluated their post-operative opioid consumption and patient satisfaction.

RESULTS: In all 3 patients, there was no additional opioid consumption during the first 24 h after the block. Numeric Rating Scale (NRS) for pain was less than 6 for the first 24 h. Women were all very satisfied with the quality of pain relief.

DISCUSSION: Quadratus Lumborum block may be a promising anesthetic adjuvant for post-cesarean analgesia. Further randomized controlled trials are needed to compare the efficacy of the Quadratus Lumborum block with intrathecal opioids.

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