Eur J Pediatr Surg
DOI: 10.1055/s-0040-1722223
Original Article

Is Ultrasound-Guided Single-Shot Quadratus Lumborum Block a Viable Alternative to a Caudal Block in Pediatric Urological Surgery?

Shahar Rotem
1  Department of Urology, Shaare Zedek Medical Center, Jerusalem, Israel
,
1  Department of Urology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Israel A. Ostrovsky
2  Department of Anesthesiology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Stanislav Kocherov
3  Department of Pediatric Urology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Jawdat Jaber
3  Department of Pediatric Urology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Alexander Zeldin
2  Department of Anesthesiology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Elena Feldman
2  Department of Anesthesiology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Yaacov Gozal
2  Department of Anesthesiology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Boris Chertin
1  Department of Urology, Shaare Zedek Medical Center, Jerusalem, Israel
› Author Affiliations
Funding None.

Abstract

Objective To review our experience with quadratus lumborum block (QLB) in pediatric urology.

Materials and Methods This mixed prospective-retrospective study included 41 patients who received QLB following induction of general anesthesia. Data collected included: the duration of block induction, surgery, hospitalization, postoperative pain score, and the use of rescue analgesia. The results were compared with a matched cohort of patients who received caudal block (CB) during similar surgeries from our retrospectively acquired data registry.

Results There was no difference between the type and length of surgery, weight, sex, and age of the patients between the two groups. The duration of block induction was significantly shorter in the CB group compared with the QLB group (35.6 ± 14.6 vs. 239 ± 33.4 seconds [p < 0.0001]). There was no difference between the groups in pain scores at 1, 4, and 24 hours postoperatively, in the time to first rescue analgesia, or in the postoperative opioid requirements. However, the QLB group required more rescue analgesia compared with CB group (p = 0.016). Finally, no differences were found in the use of rescue analgesics at home, pain record behavior, and overall satisfaction.

Conclusion Our data show that QLB might serve as a viable alternative to CB in pediatric urological surgery.



Publication History

Received: 08 August 2020

Accepted: 25 November 2020

Publication Date:
10 January 2021 (online)

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