Case Report: Opioid-sparing general anesthesia with bilateral quadratus lumborum block for cesarean delivery in a...

For parturients with contraindications to neuraxial anesthesia, GA remains the primary alternative. However, conventional opioid-based GA may increase the risk of adverse neonatal outcomes. Therefore, exploring opioid-sparing GA combined with bilateral QLB is of considerable clinical value for reducing potential maternal and neonatal risks.In the present case, the patient was a 35-year-old full-term parturient with spinal deformity who declined neuraxial anesthesia, constituting a contraindication to such techniques.During cesarean delivery, we successfully implemented an opioid-sparing GA regimen combined with bilateral QLB. The essential components of GA-hypnosis, analgesia, muscle relaxation, and attenuation of the stress response-were achieved through a multimodal approach. The anesthetic management was carefully designed following a comprehensive preoperative evaluation and a thorough analysis of the challenges associated with conventional opioid-based GA in this patient. Multidisciplinary collaboration and meticulous perioperative planning were emphasized throughout the peripartum period. This anesthetic approach effectively integrated the advantages of regional nerve block and GA. Notably, the neonate exhibited no signs of opioid-related respiratory depression, with no occurrence of low Apgar scores, and no resuscitative interventions were required after delivery. This case highlights a novel opioid-sparing strategy for cesarean delivery under GA.