Cardoso José Miguel, Sá Miguel, Reis Hugo, Almeida Liliana, Sampaio José Carlos, Pinheiro Célia, Machado Duarte
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal.
Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Controle da Dor, Portugal.
Braz J Anesthesiol. 2018 Mar-Apr;68(2):186-189. doi: 10.1016/j.bjan.2016.09.009. Epub 2016 Sep 28.
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.
An 80 year-old, ASA III, male patient, weighting 50 kg, 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 10 mL of levobupivacaine 0.25% and 5 mL of mepivacaine 1%, per side. Pain relief was achieved 5 minutes after injection and the patient referred no pain in the immediate postoperative period.
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.
腰方肌阻滞是最近被描述的一种技术，在腹部手术中作为一种镇痛技术已显示出良好效果，有可能显著减少阿片类药物的使用量，并且是硬膜外导管的一种有效替代方法。我们对一名接受胃大部切除术的脓毒症患者实施了II型腰方肌阻滞用于镇痛。
一名80岁、ASA III级、体重50公斤的男性患者，有动脉高血压和高胆固醇血症病史，因化脓性腹膜炎诊断为脓毒症，接受了开腹手术。术前在双侧超声引导下实施II型腰方肌阻滞，每侧使用10毫升0.25%的左旋布比卡因和5毫升1%的甲哌卡因。注射后5分钟实现了疼痛缓解，患者在术后即刻未诉疼痛。
对于有硬膜外导管置入一些相对禁忌证的接受大型腹部手术的脓毒症患者，II型腰方肌阻滞可被视为术后镇痛的一种有效替代方法。它使我们能够在避免使用阿片类药物的情况下实现出色的疼痛管理。然而，仍需要更多报告来恰当评估其效用。
