Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing Pyeloplasty
Post-operative analgesic management is challenging in infants and opioids have been the standard of care. However, they are associated with adverse effects which may negatively impact infants. In this retrospective cohort study, we sought to explore the postoperative analgesic efficacy of quadratus...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Surgeries |
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| Online Access: | https://www.mdpi.com/2673-4095/2/3/28 |
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| author | Paul F. Chisolm Nikhi P. Singh Ian Cummins Robert A. Oster Damon Cox Pankaj P. Dangle |
| author_facet | Paul F. Chisolm Nikhi P. Singh Ian Cummins Robert A. Oster Damon Cox Pankaj P. Dangle |
| author_sort | Paul F. Chisolm |
| collection | DOAJ |
| description | Post-operative analgesic management is challenging in infants and opioids have been the standard of care. However, they are associated with adverse effects which may negatively impact infants. In this retrospective cohort study, we sought to explore the postoperative analgesic efficacy of quadratus lumborum (QL) block in the infant population undergoing dorsal lumbotomy pyeloplasty. Chart review of 34 infants (≤12 months) who underwent dorsal lumbotomy pyeloplasty between 2016–2020 was performed. Post-operative pain was assessed using externally validated pain scales (CRIES & FLACC) and monitored hemodynamics (pulse and blood pressure). Opioid doses were standardized by using morphine milligram equivalency (MME). The Prescription Database Monitoring Program (PDMP) was utilized to determine if discharge opioid prescriptions were filled. Of 34 patients, 13 received the QL block. Mean age at the time of surgery was 6.2 months ± 3.2 months. The QL group received 0.8 MME postoperatively, whereas the non-QL group received 0.9 MME (<i>p</i> = 0.82). The QL group (20%) filled their discharge opioid prescription less frequently compared to non-QL group (100%) (<i>p</i> = 0.002). There were no observed differences between pain scale or hemodynamic variables. Further studies are warranted to explore QL block’s efficacy for post-operative infant pain management. |
| first_indexed | 2024-03-10T07:12:20Z |
| format | Article |
| id | doaj.art-34dfffd1db2a43b9bb182cda0423cd6f |
| institution | Directory Open Access Journal |
| issn | 2673-4095 |
| language | English |
| last_indexed | 2024-03-10T07:12:20Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgeries |
| spelling | doaj.art-34dfffd1db2a43b9bb182cda0423cd6f2023-11-22T15:18:35ZengMDPI AGSurgeries2673-40952021-08-012327828510.3390/surgeries2030028Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing PyeloplastyPaul F. Chisolm0Nikhi P. Singh1Ian Cummins2Robert A. Oster3Damon Cox4Pankaj P. Dangle5School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USASchool of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USASchool of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USASchool of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USADepartment of Anesthesiology, Children’s of Alabama, Birmingham, AL 35294, USADepartment of Urology, University of Alabama at Birmingham, Birmingham, AL 35294, USAPost-operative analgesic management is challenging in infants and opioids have been the standard of care. However, they are associated with adverse effects which may negatively impact infants. In this retrospective cohort study, we sought to explore the postoperative analgesic efficacy of quadratus lumborum (QL) block in the infant population undergoing dorsal lumbotomy pyeloplasty. Chart review of 34 infants (≤12 months) who underwent dorsal lumbotomy pyeloplasty between 2016–2020 was performed. Post-operative pain was assessed using externally validated pain scales (CRIES & FLACC) and monitored hemodynamics (pulse and blood pressure). Opioid doses were standardized by using morphine milligram equivalency (MME). The Prescription Database Monitoring Program (PDMP) was utilized to determine if discharge opioid prescriptions were filled. Of 34 patients, 13 received the QL block. Mean age at the time of surgery was 6.2 months ± 3.2 months. The QL group received 0.8 MME postoperatively, whereas the non-QL group received 0.9 MME (<i>p</i> = 0.82). The QL group (20%) filled their discharge opioid prescription less frequently compared to non-QL group (100%) (<i>p</i> = 0.002). There were no observed differences between pain scale or hemodynamic variables. Further studies are warranted to explore QL block’s efficacy for post-operative infant pain management.https://www.mdpi.com/2673-4095/2/3/28pediatric urologypyeloplastynerve blockquadratus lumborum block |
| spellingShingle | Paul F. Chisolm Nikhi P. Singh Ian Cummins Robert A. Oster Damon Cox Pankaj P. Dangle Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing Pyeloplasty Surgeries pediatric urology pyeloplasty nerve block quadratus lumborum block |
| title | Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing Pyeloplasty |
| title_full | Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing Pyeloplasty |
| title_fullStr | Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing Pyeloplasty |
| title_full_unstemmed | Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing Pyeloplasty |
| title_short | Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing Pyeloplasty |
| title_sort | analgesic efficacy of quadratus lumborum block in infants undergoing pyeloplasty |
| topic | pediatric urology pyeloplasty nerve block quadratus lumborum block |
| url | https://www.mdpi.com/2673-4095/2/3/28 |
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