Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk

Guangchao Zhang; Min Xu; Xiao Wang

doi:doi:10.11648/ijacm.20241201.12

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Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk

Guangchao Zhang, Min Xu, Xiao Wang^*

Published in International Journal of Anesthesia and Clinical Medicine (Volume 12, Issue 1)

Received: 14 January 2024 Accepted: 29 January 2024 Published: 5 February 2024

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Abstract

Background: Quadratus lumborum (QL) block is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle to provide effective analgesia for abdominal procedures. We presented the feasibility of using this technique as the sole anesthetic technique for giant inguinal herniorrhaphy repair by observing intraoperative and postoperative analgesic effects in patients. Case: We present an elderly patient with complex comorbidities who was hospitalized for a left inguinal hernia that fell into the scrotum and formed a huge hernial sac. Comorbidities include hypertension, atrial fibrillation, and chronic obstructive pulmonary disease. After adequate preoperative evaluation, the anesthesiologist scheduled to perform QL block as the sole anesthetic technique to complete a giant inguinal herniorrhaphy with 30 mL of ropivacaine (0.33%). Intraoperative hemodynamics was stable, the patient did not complain discomfort and pain. And no additional analgesics or local infiltration anesthesia was required. The patient was able to move 6 hours after surgery and received the first analgesia 14 hours later. He was discharged one day later, without recurrence after one year of follow-up. Conclusions: Our experience suggests that QL block with 30 mL of ropivacaine (0.33%) may be an effective intraoperative anesthesia technique suitable for elderly patients with complex complications undergoing giant inguinal hernia repair surgery, and a represents a viable alternative approach to general and neuraxial anesthesia.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 12, Issue 1)
DOI	10.11648/ijacm.20241201.12
Page(s)	7-10
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Quadratus Lumborum Block, Inguinal Herniorrhaphy, Anesthetic Method

References

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[4]	Priyadarshini, K., Behera, B. K., Tripathy, B. B., et al. Ultrasound-guided transverse abdominis plane block, ilioinguinal/iliohypogastric nerve block, and quadratus lumborum block for elective open inguinal hernia repair in children: a randomized controlled trial. Regional anesthesia and pain medicine. 2022, 47(4), 217-221. doi: 10.1136/rapm-2021-103201.
[5]	Samerchua, A., Leurcharusmee, P., Panichpichate, K., et al. A Prospective, randomized comparative study between ultrasound-guided posterior quadratus lumborum block and ultrasound-guided ilioinguinal/iliohypogastric nerve block for pediatric inguinal herniotomy. Paediatric anaesthesia. 2020, 30(4) 498-505. doi: 10.1111/pan.13837.
[6]	Yadav, M., Agrawal, M., Bansal, P., et al. Ultrasound-guided quadratus lumborum block versus ilioinguinal-iliohypogastric nerve block with wound infiltration for postoperative analgesia in unilateral inguinal surgeries: A randomised controlled trial. Indian journal of anaesthesia. 2023, 67(3), 302-306. doi: 10.4103/ija.ija_578_22.
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[10]	Tagliafico, A., Bignotti, B., Cadoni, A., et al. Anatomical study of the iliohypogastric, ilioinguinal, and genitofemoral nerves using high-resolution ultrasound. Muscle & nerve. 2015, 51(1), 42-48. doi: 10.1002/mus.24277.
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[12]	Reinpold, W., Schroeder, A. D., Schroeder, M., et al. Retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve: consequences for prevention and treatment of chronic inguinodynia. Hernia: the journal of hernias and abdominal wall surgery. 2015, 19(4), 539-548. doi: 10.1007/s10029-015-1396-z.
[13]	Blanco, R., Ansari, T., Girgis, E. Quadratus lumborum block for postoperative pain after caesarean section: A randomised controlled trial. European journal of anaesthesiology. 2015, 32(11), 812-818. doi: 10.1097/eja.0000000000000299.
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APA Style

Zhang, G., Xu, M., Wang, X. (2024). Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk. International Journal of Anesthesia and Clinical Medicine, 12(1), 7-10. https://doi.org/10.11648/ijacm.20241201.12

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ACS Style

Zhang, G.; Xu, M.; Wang, X. Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk. Int. J. Anesth. Clin. Med. 2024, 12(1), 7-10. doi: 10.11648/ijacm.20241201.12

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AMA Style

Zhang G, Xu M, Wang X. Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk. Int J Anesth Clin Med. 2024;12(1):7-10. doi: 10.11648/ijacm.20241201.12

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@article{10.11648/ijacm.20241201.12,
  author = {Guangchao Zhang and Min Xu and Xiao Wang},
  title = {Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {12},
  number = {1},
  pages = {7-10},
  doi = {10.11648/ijacm.20241201.12},
  url = {https://doi.org/10.11648/ijacm.20241201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.ijacm.20241201.12},
  abstract = {Background: Quadratus lumborum (QL) block is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle to provide effective analgesia for abdominal procedures. We presented the feasibility of using this technique as the sole anesthetic technique for giant inguinal herniorrhaphy repair by observing intraoperative and postoperative analgesic effects in patients. Case: We present an elderly patient with complex comorbidities who was hospitalized for a left inguinal hernia that fell into the scrotum and formed a huge hernial sac. Comorbidities include hypertension, atrial fibrillation, and chronic obstructive pulmonary disease. After adequate preoperative evaluation, the anesthesiologist scheduled to perform QL block as the sole anesthetic technique to complete a giant inguinal herniorrhaphy with 30 mL of ropivacaine (0.33%). Intraoperative hemodynamics was stable, the patient did not complain discomfort and pain. And no additional analgesics or local infiltration anesthesia was required. The patient was able to move 6 hours after surgery and received the first analgesia 14 hours later. He was discharged one day later, without recurrence after one year of follow-up. Conclusions: Our experience suggests that QL block with 30 mL of ropivacaine (0.33%) may be an effective intraoperative anesthesia technique suitable for elderly patients with complex complications undergoing giant inguinal hernia repair surgery, and a represents a viable alternative approach to general and neuraxial anesthesia.
},
 year = {2024}
}

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TY  - JOUR
T1  - Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk
AU  - Guangchao Zhang
AU  - Min Xu
AU  - Xiao Wang
Y1  - 2024/02/05
PY  - 2024
N1  - https://doi.org/10.11648/ijacm.20241201.12
DO  - 10.11648/ijacm.20241201.12
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 7
EP  - 10
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/ijacm.20241201.12
AB  - Background: Quadratus lumborum (QL) block is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle to provide effective analgesia for abdominal procedures. We presented the feasibility of using this technique as the sole anesthetic technique for giant inguinal herniorrhaphy repair by observing intraoperative and postoperative analgesic effects in patients. Case: We present an elderly patient with complex comorbidities who was hospitalized for a left inguinal hernia that fell into the scrotum and formed a huge hernial sac. Comorbidities include hypertension, atrial fibrillation, and chronic obstructive pulmonary disease. After adequate preoperative evaluation, the anesthesiologist scheduled to perform QL block as the sole anesthetic technique to complete a giant inguinal herniorrhaphy with 30 mL of ropivacaine (0.33%). Intraoperative hemodynamics was stable, the patient did not complain discomfort and pain. And no additional analgesics or local infiltration anesthesia was required. The patient was able to move 6 hours after surgery and received the first analgesia 14 hours later. He was discharged one day later, without recurrence after one year of follow-up. Conclusions: Our experience suggests that QL block with 30 mL of ropivacaine (0.33%) may be an effective intraoperative anesthesia technique suitable for elderly patients with complex complications undergoing giant inguinal hernia repair surgery, and a represents a viable alternative approach to general and neuraxial anesthesia.

VL  - 12
IS  - 1
ER  -

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Author Information

Guangchao Zhang

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
Min Xu

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
Xiao Wang

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China

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Plain Text BibTeX RIS

APA Style

Zhang, G., Xu, M., Wang, X. (2024). Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk. International Journal of Anesthesia and Clinical Medicine, 12(1), 7-10. https://doi.org/10.11648/ijacm.20241201.12

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ACS Style

Zhang, G.; Xu, M.; Wang, X. Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk. Int. J. Anesth. Clin. Med. 2024, 12(1), 7-10. doi: 10.11648/ijacm.20241201.12

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AMA Style

Zhang G, Xu M, Wang X. Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk. Int J Anesth Clin Med. 2024;12(1):7-10. doi: 10.11648/ijacm.20241201.12

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@article{10.11648/ijacm.20241201.12,
  author = {Guangchao Zhang and Min Xu and Xiao Wang},
  title = {Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {12},
  number = {1},
  pages = {7-10},
  doi = {10.11648/ijacm.20241201.12},
  url = {https://doi.org/10.11648/ijacm.20241201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.ijacm.20241201.12},
  abstract = {Background: Quadratus lumborum (QL) block is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle to provide effective analgesia for abdominal procedures. We presented the feasibility of using this technique as the sole anesthetic technique for giant inguinal herniorrhaphy repair by observing intraoperative and postoperative analgesic effects in patients. Case: We present an elderly patient with complex comorbidities who was hospitalized for a left inguinal hernia that fell into the scrotum and formed a huge hernial sac. Comorbidities include hypertension, atrial fibrillation, and chronic obstructive pulmonary disease. After adequate preoperative evaluation, the anesthesiologist scheduled to perform QL block as the sole anesthetic technique to complete a giant inguinal herniorrhaphy with 30 mL of ropivacaine (0.33%). Intraoperative hemodynamics was stable, the patient did not complain discomfort and pain. And no additional analgesics or local infiltration anesthesia was required. The patient was able to move 6 hours after surgery and received the first analgesia 14 hours later. He was discharged one day later, without recurrence after one year of follow-up. Conclusions: Our experience suggests that QL block with 30 mL of ropivacaine (0.33%) may be an effective intraoperative anesthesia technique suitable for elderly patients with complex complications undergoing giant inguinal hernia repair surgery, and a represents a viable alternative approach to general and neuraxial anesthesia.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk
AU  - Guangchao Zhang
AU  - Min Xu
AU  - Xiao Wang
Y1  - 2024/02/05
PY  - 2024
N1  - https://doi.org/10.11648/ijacm.20241201.12
DO  - 10.11648/ijacm.20241201.12
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 7
EP  - 10
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/ijacm.20241201.12
AB  - Background: Quadratus lumborum (QL) block is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle to provide effective analgesia for abdominal procedures. We presented the feasibility of using this technique as the sole anesthetic technique for giant inguinal herniorrhaphy repair by observing intraoperative and postoperative analgesic effects in patients. Case: We present an elderly patient with complex comorbidities who was hospitalized for a left inguinal hernia that fell into the scrotum and formed a huge hernial sac. Comorbidities include hypertension, atrial fibrillation, and chronic obstructive pulmonary disease. After adequate preoperative evaluation, the anesthesiologist scheduled to perform QL block as the sole anesthetic technique to complete a giant inguinal herniorrhaphy with 30 mL of ropivacaine (0.33%). Intraoperative hemodynamics was stable, the patient did not complain discomfort and pain. And no additional analgesics or local infiltration anesthesia was required. The patient was able to move 6 hours after surgery and received the first analgesia 14 hours later. He was discharged one day later, without recurrence after one year of follow-up. Conclusions: Our experience suggests that QL block with 30 mL of ropivacaine (0.33%) may be an effective intraoperative anesthesia technique suitable for elderly patients with complex complications undergoing giant inguinal hernia repair surgery, and a represents a viable alternative approach to general and neuraxial anesthesia.

VL  - 12
IS  - 1
ER  -

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