Shaaban Mohamed, Esa Wael Ali Sakr, Maheshwari Kamal, Elsharkawy Hesham, Soliman Loran Mounir
From the Departments of *General Anesthesia, †Pain Management, and ‡Outcomes Research, Cleveland Clinic, Cleveland, Ohio.
A A Case Rep. 2015 Oct 1;5(7):107-11. doi: 10.1213/XAA.0000000000000188.
We present a case of acute postoperative abdominal pain after proctosigmoidectomy and colorectal anastomosis that was treated by bilateral continuous quadratus lumborum block. The block was performed in the lateral position under ultrasound guidance with a 15-mL bolus of 0.5% bupivacaine injected anterior to the quadratus lumborum muscle followed by bilateral catheter placement. Each catheter received a continuous infusion of 0.1% bupivacaine at 8 mL/h and an on-demand bolus 5 mL every 30 minutes. Sensory level was confirmed by insensitivity to cold from T7 through T12. The block was devoid of hemodynamic side effects or motor weakness. This case demonstrates that bilateral continuous quadratus lumborum catheters can provide extended postoperative pain control.
我们报告一例直肠乙状结肠切除术后及结直肠吻合术后急性腹痛患者，通过双侧连续腰方肌阻滞进行治疗。该阻滞在超声引导下于侧卧位进行，在腰方肌前方注入15毫升0.5%布比卡因大剂量注射液，随后双侧放置导管。每个导管以8毫升/小时的速度持续输注0.1%布比卡因，并每30分钟按需推注5毫升。通过T7至T12区域对冷刺激无感觉来确认感觉平面。该阻滞未出现血流动力学副作用或运动无力。本病例表明双侧连续腰方肌导管可提供延长的术后疼痛控制。
