Postoperative Pain Clinical Trial
Official title:
Quadratus Lumborum Block for Postoperative Pain Control in Patients Undergoing Unilateral Inguinal Hernia Repair, a Comparative Study Between Two Approaches
A significant component of pain experienced after abdominal surgery is related to incision of
the abdominal wall and adequate analgesia can be a challenge.
The ultrasound-guided (USG) quadratus lumborum block QLB was first described by Rafael Blanco
in a presentation at ESRA 2007 at the XXVI Annual ESRA Congress in Valencia, Spain. Blanco
described a potential space posterior to the abdominal wall muscles and lateral to the
quadratus lumborum muscle where Local anesthetics can be injected. This technique provide
analgesia after abdominal surgery due to spread of LA from its lumbar deposition cranially
into the thoracic paravertebral space where lateral and anterior cutaneous branches from Th7
to L1 can be blocked . This was proved by Carney et al. who found traces of contrast agent in
the TPVS following application of this block A novel USG QL block is the transmuscular
approach which relies on clearly identifiable sonographic bony landmarks, Where the needle is
advanced through the QL muscle, penetrating the ventral proper fascia of the QL muscle and LA
is finally injected between the QL and Psoas major (PM) muscle. The transmuscular QL block
does not result in redundant antero-lateral spread of the injectate. This may indicate that
lower volumes of LA potentially can be used and yet provide extensive thoracolumbar
anesthesia.
This study was designed to compare the duration of analgesia provided by the original QLB and
transmuscular QLB in patients undergoing surgical repair of unilateral inguinal hernia.
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