Evaluación del bloqueo del cuadrado lumbar transmuscular ecoguiado en pediatría

Abstract

Transmuscular quadratus lumborum block (TQLB) is a novel regional anaesthesia technique that has proven to be effective for postoperative pain reduction in different abdominal surgical procedures. The present study evaluated its efficacy on pain intensity and analgesic consumption in children undergoing low abdominal surgery. The study included forty patients, aged 1 to 6 years, scheduled for low abdominal surgery (hernia repair or orchiopexy) under general anaesthesia. They were enrolled in two groups: TQLB block plus systemic analgesia (group 1; n = 20) wound infiltration done by the surgeon plus systemic analgesia (Group 2; n = 20). All blocks were performed by the same anesthesiologist under general anaesthesia before surgery. Both groups received the same systemic analgesia protocol. Analgesic consumption (ibuprofen) within the first 24 postoperative hours, pain intensity scores (FLACC scale) at 60 minutes, 2, 6 and 24 hours after surgery, time in which the first analgesia was required, satisfaction levels of the parents (0-10), adverse events related to systemic analgesia and time to hospital discharge were evaluated and registered. We found differences between both groups in ibuprofen consumption (80 mg 185 mg; p < 0.05) and pain scores (FLACC) within the first 24 postoperative hours at each interval (p < 0.05 for every point in time analyzed). Time in which the first analgesia was required was longer for the TQLB group (18 10 hours; p < 0.05). Satisfaction levels of the parents were also higher in the first group (p < 0.05). Adverse events related to medication and time to hospital discharge showed similar results. Further investigation comparing the TQLB with different approaches of QLB or conventional TAP block could be interesting and is required in a near future.