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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.d.19.00016    [Epub ahead of print]
Published online May 17, 2019.
The continuous quadratus lumborum block for multimodal analgesia after total hip arthroplasty
Hahyeon Bak1,2, Seunguk Bang1,2, Subin Yoo1,2, Seoyeong Kim1,2, So Yeon Lee1,2
1Department of Anesthesiology and Pain Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
2Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Corresponding author:  Seunguk Bang, Tel: +82-42-220-9046, Fax: +82-42-220-3500, 
Email: seungukb@naver.com
Received: 13 January 2019   • Revised: 30 April 2019   • Accepted: 14 May 2019
Abstract
The quadratus lumborum block (QLB), which is based on an easy fascial plane technique that has been reported to be effective in pain control after abdominal surgery. Here we report a case involving an 83-year-old man (weight: 64 kg) who received continuous transmuscular QLB as part of a multimodal analgesia after hardware removal and total hip arthroplasty. The patient received continuous infusion of 0.2% ropivacaine at 8 mL/h through an indwelling catheter in addition to patient-controlled analgesia (PCA) with intravenous fentanyl and oral celecoxib. The area of sensory blockade ranged from T8 to L3, and he received the first demand dose of fentanyl via the PCA pump at 17 h after surgery. The patient’s pain scores did not exceed 4, and no additional analgesics were required until postoperative day 5. Our findings suggest that transmuscular QLB may be a suitable option for multimodal analgesia after total hip arthroplasty.
Key Words: analgesia; arthroplasty; catheters; nerve block; pain; ropivacaine; ultrasonography


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