Ultrasound-Guided Quadratus Lumborum Block Versus Caudal Block for Perioperative-Ultrasound-Guided Quadratus Lumborum Block Versus Caudal Block for Perioperative

Ultrasound-Guided Quadratus Lumborum Block Versus Caudal Block for Perioperative

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This study, published in the AANA Journal in October 2024, examines the efficacy of two analgesic techniques in pediatric patients undergoing open pyeloplasty: caudal block and ultrasound-guided quadratus lumborum block (QLB). The randomized, controlled study involved 50 pediatric patients, aged over 4 years and weighing over 16 kg, who were scheduled for elective surgery under general anesthesia. These patients were divided into two groups to receive either a caudal block or a QLB.<br /><br />The study found that QLBs provided significantly prolonged postoperative analgesia compared to caudal blocks. Specifically, the mean duration of analgesia was 11.27 hours with QLB, versus 6.85 hours for caudal blocks. Furthermore, postoperative pain scores and paracetamol consumption were lower in the QLB group, indicating better pain management. Both techniques showed no significant difference in intraoperative fentanyl requirement or postoperative hemodynamic stability. Importantly, no adverse effects were associated with either block.<br /><br />The study highlights that the QLB is a superior alternative to caudal blocks for postoperative pain management in pediatric surgical patients, primarily due to its longer duration of action and less need for additional postoperative analgesics. The findings suggest that, provided the necessary expertise and equipment are available, QLB should be considered over caudal blocks, especially given its potential for fewer complications related to central neuraxial techniques.<br /><br />Overall, this research not only underscores the efficacy of quadratus lumborum block in pediatric anesthesia but also contributes to an evolving interest in regional anesthesia techniques that offer enhanced safety and effectiveness.

Keywords

pediatric anesthesia

open pyeloplasty

caudal block

quadratus lumborum block

postoperative analgesia

regional anesthesia

pain management

AANA Journal

randomized controlled study

pediatric surgery