[Type II Quadratus Lumborum block for a sub-total gastrectomy in a septic patient].
OBJECTIVE
Quadratus Lumborum block was recently described and has already shown good results as an analgesic technique in abdominal surgeries, having the potential to significantly reduce opioids consumption and be a valid alternative to epidural catheter. We performed a type II Quadratus Lumborum block for analgesia in a septic patient having a sub-total gastrectomy.


METHODS
An 80 year-old, ASA III, male patient, weighting 50kg, with a history of arterial hypertension and hypercholesterolemia, diagnosed with sepsis due to purulent peritonitis was submitted to an open laparotomy. Bilateral ultrasound-guided type II Quadratus Lumborum block was performed before surgery, using 10mL of levobupivacaine 0.25% and 5mL of mepivacaine 1%, per side. Pain relief was achieved 5minutes after injection and the patient referred no pain in the immediate postoperative period.


CONCLUSIONS
Type II Quadratus Lumborum block may be considered a valid alternative for postoperative analgesia in a septic patient undergoing major abdominal surgery with some relative contraindications to epidural catheter placement. It allowed us to achieve excellent pain management avoiding opioids usage. However, more reports are still needed to properly access its usefulness.
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal. Electronic address: josemiguelxcardoso@gmail.com.
José Miguel
JM
Cardoso
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal.
Miguel
M
Sá
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal.
Hugo
H
Reis
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal.
Liliana
L
Almeida
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal.
José Carlos
JC
Sampaio
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal.
Célia
C
Pinheiro
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal.
Duarte
D
Machado
D000009:Abdominal Muscles; D000369:Aged, 80 and over; D000698:Analgesia; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000379:methods*; D018805:Sepsis / Q000150:complications; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*
Dor; Gastrectomia; Gastrectomy; Pain; Peritonite; Peritonitis; Quadrado lombar; Quadratus Lumborum; Ultrasound; Ultrassom
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21851346
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Anesth Analg. 2013 Aug;117(2):507-13
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Paediatr Anaesth. 2013 Oct;23(10):959-61
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