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Abstract
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Background and Aims Multiple-level lumbar discectomies are frequently performed to alleviate pain and neurological symptoms caused by lumbar disc herniation. Despite the routine nature of these surgeries, postoperative pain management remains a critical challenge. In this context, we introduce a novel regional anesthesia technique, the Quadro-iliac plane block (QIPB), which targets the posterior aspect of the Qadratus Lumborum Muscle at its attachment to the inner surface of the iliac crest.
Methods Patients were assessed at 0/1/6/12/24 hours post-surgery. This case series included five patients who underwent lumbar stabilization (multi-level discectomies). The blocks were administered before changing the patient‘s position from prone to supine, with a total of 100mg of 0.25% bupivacaine applied bilaterally (figure 1). All patients received the same analgesic regimen in perioperative period; 100mg tramadol, 1g paracetamol, and 50mg dexketoprofen intravenously. Additionally, 1g paracetamol was administered intravenously three times a day.
Results The mean Visual Analogue Scale (VAS) scores at rest were 2.4/1.8/1.8/1.4/3 at 0/1/6/12/24 hours postoperatively, respectively. For VAS scores with movement, the means were 2.8/2.0/1.8/1.8/3.4 at the same time points. None of the patients required rescue analgesia within the first 12 hours. However, three patients required rescue analgesia (100mg tramadol) at the 16th hour. None of the patients experienced nausea, vomiting, or motor blockage.
Conclusions In conclusion, our findings suggest that the QIPB could be a valuable addition to the arsenal of regional anesthesia techniques for spinal surgeries, providing effective and targeted pain relief with the potential to improve patient recovery and satisfaction.
Quadro-Iliac Plane block( Iliac Crest, Quadratus Lumborum Muscle)