A Novel Approach for Transmuscular Quadratus Lumborum Block

Alexandria University

Status

Completed

Conditions

Transmuscular Quadratus Lumborum Block Hip Surgery

Treatments

Procedure: transmuscular quadratus lumborum block

Study type

Interventional

Funder types

Other

Identifiers

NCT03733769

TQL block in hip surgery

Details and patient eligibility

About

a novel approach for TQL (anterior Q.L) block aiming mainly for terminal branches of lumbar plexus. The technique is described as Para-Spinous Saggital Shift Q.L block, done at L4 transverse process level in saggital orientation.

Full description

With this approach, we think it has advantages of easy identification, better caudal LA spread till under fascia iliaca, with the psoas major muscle provides a better protective barrier against accidental needle entry into the peritoneal cavity, the endpoint is injection within a fascial plane, rather than a specific motor response contact where the lumbar plexus stimulation is not sought, so there is minimal risk of nerve injury, inadvertent dural cuff puncture and intrathecal spread of local anesthetic. And finally optimal insertion of catheter in long axis of Q.L and psoas major if continuous analgesia is planned.

Enrollment

4 patients

Sex

All

Ages

18 to 70 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Orthopaedic patients, American Society of Anesthesiologists (ASA) physical status I-III, scheduled to undergo unilateral hip surgery.

Exclusion criteria

History of neurological/neuromuscular, psychiatric disease, dementia preventing proper comprehension.
Patients with Body Mass Index (BMI) <18.5 or >30 kg/m2.
Coagulation disturbances (INR>1.4, platelet count<100 000).
History of opioid dependence (opioid use within the last 4 weeks).
History of allergies to study medications.