Ultrasound-guided continuous transmuscular quadratus lumborum block- L4 or L2 level catheter insertion for analgesia in open abdominal surgery: Case series

Quadratus lumborum block (QLB) is a technique for postoperative analgesia after abdominal surgeries. Nomenclature on types of QLB keeps changing.[1] An ultrasound-guided transmuscular quadratus lumborum (TQL) block, which involves passage of the needle through the QL muscle and injection of the local anaesthetic (LA) into the anterior aspect of the fascial interspace between the QL and psoas muscle is also called the QLB3.[2] There have been case reports on the use QLB block in abdominal surgery as an analgesic technique in paediatric and adult patients.[3,4,5] There is a general paucity of literature on continuous use of TQL block in adults for major abdominal surgery.[6,7] We have previously reported TQL block performed at L4 resulting in transient paraesthesia of the leg in one case.[6] In view of this issue, we performed the same block at L2 level without adverse effect. So far, no studies examined the analgesic effect of TQL catheters placed at different levels utilizing the anterior approach for major abdominal surgery. The aim of this study was to evaluate the efficacy of these blocks at two levels in open midline incision surgery.