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Background and Aims Postoperative pain in patients undergoing kidney transplantation is classified as moderate to severe. We tested the efficacy of the Posterior Quadratus Lumborum Block (QLB2) as postoperative analgesia.

Methods Twenty-six ASA Class IV patients, were enrolled after approval by Hippokrateion Hospital Ethical Committee (Reg.no17068/10-04-2023). Basic monitoring was applied. Induction and maintenance were performed according to standard practice. All patients being placed in lateral decubitus position, QLB2 was performed under ultrasound control prior to emergence with a high frequency linear probe (6-12Hz) placed in transverse orientation at the midaxillary line (MindrayTM TE9 Ultrasound System, China). Using an in-plane technique, the needle (Stimuplex® Ultra 22G-90mm, B. Braun,) was inserted toward the posterior aspect of the QL muscle. After aspiration, negative for blood, 20mL levobupivacaine 0.375%, 0.4 mL/Kg3 was administered. All patients met extubation criteria and were extubated in the OR. Visual Analogue Scale (VAS) was evaluated on the 1st, 4th, 8th, 12th and 24th postoperative hours.

Results All 26 patients described mild pain on the 1st and 4thh. Two of them suffered moderate pain on the 8th h while the remaining 24 only mild. After the 12thh 10 patients had moderate pain and paracetamol (1g) was administered. By the 24thh, all patients were experiencing mild pain on movement without postoperative nausea, vomiting or drowsiness. Paracetamol (1g) was started after the 24thh with no need of other analgesic. [table 1].

Conclusions QLB2 significantly reduced postoperative pain and may be recommended as a valuable alternative for analgesic control in patients with renal function at risk.

Attachment Registration Number 1706810-4-2023.pdf