Abstract
The use of truncal nerve blocks has been described since 2001. Since then, there have been many studies trying to understand the ideal clinical scenarios for its use. Since 2001, the transversus abdominis plane block has evolved in many ways including from landmark based technique to ultrasound guided and more recently, into the quadratus lumborum (QL) block. Its anatomical placement, concentration of local anesthetic, volume of local anesthetic, and anatomic placement have all been raised as clinical questions. This article will discuss the literature of the QL block in an effort to understand how it is best used in a variety of clinical scenarios.
Highlights
The truncal nerve blocks, as a part of perioperative pain management, were introduced into clinical practice over 40 years ago
The anatomical markers are reliably detected by ultrasound, the blocks of the anterior abdominal wall vary in both the distribution of the local anesthetics and the field of coverage
The crucial ultrasound landmark for block performance is the quadratus lumborum muscle (QLM), and the key to the analgesia lies in the thoracolumbar fascia (TLF) [12,13,14,15]
Summary
The truncal nerve blocks, as a part of perioperative pain management, were introduced into clinical practice over 40 years ago. In the early years of the 21st century, the transversus abdominis plane (TAP) block was introduced in everyday practice, providing a much wider field of analgesia [6, 7]. At first, these blocks were performed without ultrasound guidance, using landmark techniques. Quadratus lumborum block is a block of the posterior abdominal wall, “interfascial plane block,” which is performed exclusively under ultrasound guidance It was described by anesthesiologist Dr Rafael Blanco [8] as a variant of the TAP block in 2007. There has been an increasing interest of the anesthesia community in the use of truncal blocks, and the number of publications on the topic of QLB is progressively growing
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