Quadratus Lumborum Block

The transversus abdominis merges with the thoracolumbar fascia encasing the quadratus lumborum muscle. The concept of this block is like that of the posterior TAP. However, the extent of the effect appears to be greater because of possible spread into the paravertebral space and the fact that the fascial plane extends up to the diaphragm. Murouchi [1 ] observed the analgesic effects of bilateral single-shot QL block for laparoscopic surgery. Time to rescue analgesia was 21 hours, spread was demonstrated from T7-T12 following 20ml of 0.375% ropivacaine. Shaaban [2 ] described the successful use of continuous QL block in a case report for a patient who developed opioid respiratory depression following an AP resection. The catheters were placed anterior to the QL muscle following bilateral boluses of 15ml 0.5% bupivacaine.

[1] Murouchi et al. Quadratus Lumborum Block Analgesia Effects and Chronological Ropivacaine Concentrations After Laparoscopic Surgery. RAPM. Vol 41, Number 2, March-April 2016: 146-150

[2] Shaaban et al. Bilateral Continuous Quadratus Lumborum Block for Acute Postoperative Abdominal Pain as a Rescue after Opioid-Induced Respiratory Depression. A&A Case Reports. 2015; 107-11

Quadratus Lumborum Block

Video Quadratus Lumborum Block- 1 (QLB-1)

Video Quadratus Lumborum Block-3 (QLB-3)