Ultrasound-Guided Quadratus Lumborum Block as A Post-operative Analgesia for Total Abdominal Hysterectomy: A Case Report

Abstract

Total Abdominal Hysterectomy is a major invasive abdominal surgery which is accompanied with severe post-operative pain. Multimodal analgesia techniques can provide efficient analgesic coverage with minimal side effects, Quadratus Lumborum Block is an abdominal wall block which gives good analgesic effect for abdominal surgery with lower pain score and less requirement for opioids. A 67-year-old female was scheduled to undergo total abdominal hysterectomy surgery. The patient presented with comorbidities, morbid obesity, bronchial asthma, obstructive sleep apnea and hypothyroidism. The procedure was performed under general anesthesia and by the end of surgery, a Quadratus Lumborum Block was carried out using ultrasound-guided technique. Quadratus Lumborum Block bilaterally was successfully performed which was able to provide a sufficient analgesic effect post total abdominal hysterectomy, thus, provided the patient's with not only an opportunity for early ambulation but also avoided the adverse effects of opioids (especially the respiratory complications). Keywords: Quadratus Lamborum Block and Abdominal Wall Nerve Block, Asthma, General Anesthesia, Hysterectomy, Obstructive Sleep Apnea