ULTRASOUND-GUIDED QUADRATUS LUMBORUM BLOCK FOR POST OPERATIVE ANALGESIA IN PATIENT UNDERGOING ABDOMINAL SURGERY

Background: Abdominal surgery is one the most common surgical procedures. Effective postoperative analgesia may help the patients for early ambulation and can reduce the need of opioid which associated with significant adverse effects such as nausea, pruritus and vomiting. Quadratuslumborum block can provide both visceral and somatosensory pain relief. This effect was due to wider spread of the local anesthetic beyond the transversusabdominis plane into the paravertebral space. Case Illustration: We reporta case report of patient who had previously diagnosed withovarian cyst and underwentsalphingoophorectomy. We had done quadratuslumborum block procedure during the surgery for post operative analgesia using combination of ropivacaine plain and methylprednisolon. We found satisfactory pain control with Numeric Rating Scale around 1-2 during the 24 hours observation and no use of opioid analgesia in the patient. Discussion: There are different types of QuadratusLumborum Block (QLB) according to the position of the needle tip and the approach of the needle. Several approaches have been described for QLB. Lateral approach where local anesthetic is injected at the anterolateral border of the quadratuslumborum muscle, posterior approach where local anesthetic is injected at the junction of quadratuslumborum muscle with the transversalis fascia. Transmuscular QLB is where the needle is inserted between the quadratuslumborum muscle, penetrating the ventral fascia of the QL muscle ad the local anesthetic is injected between the QL muscle and psoas major muscle. recovery room to 24 hours after surgery. Conclusion: The quadratuslumborum block is safe to executeand provides effective abdominal wall and visceral analgesia. It can decrease the intensity of pain and opioid requirement when used within 24 hours after abdominal surgery.