Author : Bergek Christian
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)
Book Synopsis CASE REPORT: CONTINUOUS BILATERAL QUADRATUS LUMBORUM BLOCKS IN AN INFANT by : Bergek Christian
Download or read book CASE REPORT: CONTINUOUS BILATERAL QUADRATUS LUMBORUM BLOCKS IN AN INFANT written by Bergek Christian and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BackgroundQuadratus lumborum block (QLB) is becoming popular in paediatric anaesthesia but few mentions of continuous QLB exist.1,2Our patient was born at week 36, with bladder exstrophy. He had surgery first at birth, and 2 months later for duodenal stenosis. Now, at 6 months, weighing 6.5 kg he had surgery again to close the bladder and the abdominal wall, and bilateral pelvic osteotomies to make it possible. Postoperatively he was confined to the supine position with the legs elevated in a stretching device to release tension in the surgical area. Because of vertebral malformations (upper thorax and lower part of sacrum) any central block was deemed contraindicated. Peroperatively large doses of fentanyl was given. Postoperatively he was kept intubated in PICU until stable analgesia and respiration, which turned out to be difficult to achieve. (Table 1) MethodsAt day 2 I performed bilateral QLB blocks with catheters. The catheters were secured with Dermabondu00ae mini, and TegadermTM. For practical reasons I did a transmuscular QLB on the right side and a QLB type 2 on the left side. (Fig 1&2) Because of surgical dressings both injections were done from medial aiming laterally. Starting doses were 2.5 ml of levobupivacaine (1.6 mg/ml) on each side. Thereafter 3 ml levobupivacaine (0.625 mg/ml) on each side every 4th hour.ResultsThe patient became calmer and other analgesics could be withdrawn step by step. Catheters were withdrawn after 9 days. No side effects were noted. (Table 1)ConclusionsContinuous QLB seems applicable also in infants.