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Evaluating the technical experience of transmuscular quadratus lumborum block in prone position: a retrospective
Sukriti Jha1, Ashwin Mani1, Raga Brindha1
1Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, 5011, 5th Floor, Teaching Block, Ansari Nagar, New Delhi, India.
Background:
Traditionally quadratus lumborum block has been performed in lateral or supine positions. We propose that transmuscular or anterior quadratus lumborum block performed in a prone position may offer comparable or improved technical conditions, image quality and also aid in resident training. This study aimed to assess the technical ease of performing Tm-QLB in the prone position.
Methods:
This retrospective study included female patients undergoing elective gynecologic oncology surgery via midline incision, who received bilateral preoperative prone-position transmuscular quadratus lumborum block. Block performance was evaluated using a composite score derived from normalized ultrasound image quality, time taken, number of attempts, and redirections. Blocks were categorized into five difficulty levels based on the composite score.
Results:
Ninety blocks were analyzed. Mean age was 40.18 ± 12.05 years; BMI was 23.90 ± 1.86 kg/m2. The median composite score was 0.81 (IQR: 0.17). Over 50% of blocks were rated "Very Easy" or "Easy," reflecting high image quality, low redirection rates, and brief procedure times.
Conclusion:
Prone-position Tm-QLB is technically easy and operator-friendly, making it a viable alternative for training and clinical practice in suitable patients.
