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Anesthesia Principles II > Quadratus Lumborum Block > Flashcards

Quadratus Lumborum Block Flashcards

1
Q

Useful application of QL block?

A

abdominal surgery
ant hip surgery

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2
Q

what distribution do you get with QL block?

A

T6-L1

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3
Q

Why is QL better than TAP block?

A

get full abdominal coverage with just one block.

TAP block often requires other blocks to get full coverage

also provides visceral pain relief

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4
Q

how does QL block provide visceral pain relief?

A

from paravertebral spread

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5
Q

What pain relief does QL block provide?

A

somatic pain relief to abdominal skin, muscles, and parietal peritoneum

visceral pain relief

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6
Q

Which block is basically an extension of a TAP block?

A

QL block

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7
Q

What are the anterior/lateral wall muscles you need to be aware of for QL block?

A

rectus abdominis
external abdominal oblique
internal abdominal oblique
transversus abdominis

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8
Q

what are the posterior abdominal wall muscles/structures to be aware of for QL block?

A

erector spinae
psoas major
quadtratus lumborum
thoracolumbar fascia

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9
Q

what is important to understand about the QL fascia?

A

it is continuous with the transversus abdominus fascia

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10
Q

how many approaches are there for QL block?

A

3

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11
Q

which block position has highest chance of paravertebral spread?

A

QL 3

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12
Q

which block position has highest risk of peritoneal puncture?

A

QL 3

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13
Q

which block position is the most superficial?

A

QL2

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14
Q

which block position is the original?

A

QL1

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15
Q

which US probe would you use for QL block? And why?

A

curved transducer

because block is usually 4-8cm deep
also helps keep the long needle in view so you don’t loose it.

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16
Q

what dose of local for QL block?

A

20-40ml each side

Eddie usually uses 25ml on each side with great results

17
Q

what kind of needle do you use for QL block?

A

21g 110mm non-stimulating

18
Q

how should patient be positioned for QL block?

A

sitting, lateral decubitus, or supine

19
Q

in what postions is the QL more thin?

A

sitting and supine

20
Q

in what position is the QL the thickest?

A

lateral decubitus with hip abducted

21
Q

what other structure could you accidently hit on the Right side?

A

the liver

22
Q

what other structure could you accidently hit on the left side?

A

spleen

23
Q

what other structures could you potentially hit?

A

kindeys, liver, or spleen

24
Q

how could color flow help with this block?

A

help identify lumbar arteries that run on the post surface of the QL

25
Q

what could happen when larger volumes of LA are used in the QL block?

A

may get better paravertebral spread, but could also get lumbar plexus > leg weakness

26
Q

is there a specific billing code for QL blocks?

A

no, they are too new. Have to use the “other” code.

27
Q

Name the block and structures

A

QL block

Anesthesia Principles II (14 decks)

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