Anatomical and ultrasound description of two transmuscular quadratus lumborum block approaches at L2 level and their application in abdominal surgery

Anaesth Intensive Care. 2019 Mar;47(2):141-145. doi: 10.1177/0310057X19839931. Epub 2019 May 15.

Abstract

The transmuscular quadratus lumborum (TQL) block is one of the recently evolved myofascial blocks utilised in abdominal surgery. It involves injecting local anaesthetic into the fascial plane anterior to the thoracolumbar fascia. This block has previously been described with a transverse oblique paramedian approach at the L2 level in the sitting position. We describe a TQL block at the same level in the lateral position using a transverse posterolateral approach to provide analgesia for patients undergoing abdominal surgery. We elaborate on these two approaches of TQL block at the L2 level, in relation to the anatomy, sonoanatomy and technical aspects.

Keywords: Quadratus lumborum; postoperative analgesia; thoracolumbar fascia; transmuscular quadratus lumborum block; ultrasound.

MeSH terms

  • Abdominal Muscles
  • Analgesia*
  • Anesthetics, Local
  • Humans
  • Nerve Block* / methods
  • Ultrasonography

Substances

  • Anesthetics, Local