Use of quadratus lumborum block in gynecologic procedures

Abstract

Objective: Adequately managing post-operative pain is essential for improving patient outcomes and reducing post-operative complications. The quadratus lumborum (QL) block is a truncal nerve block technique that was recently developed to provide analgesia during abdominal and hip surgical procedures. While many studies have shown the outstanding analgesic effect of QL blocks, this technique is not well-known or commonly used in gynecologic procedures.

Findings: This narrative review describes evidence in current literature on the safety and effectiveness of QL blocks when used for gynecologic procedures. The studies show that including QL blocks as part of the approach to managing post-operative pain in gynecologic patients can reduce post-operative pain, reduce analgesic consumption, and lengthen time to first analgesic. They also suggest that QL blocks are more effective at managing post-operative pain and have a lower risk for systemic toxicity compared with transversus abdominis plane blocks.

Summary: According to current randomized controlled trials, QL blocks have been shown to be effective in managing post-operative pain after gynecologic surgical procedures. Further studies on effectiveness in different procedures, adjuvants, and optimum dosing of local anesthetic are needed to determine the best application of QL blocks in gynecologic procedures.

Keywords: Gynecologic Surgical Procedures; Opioid-Related Disorders; Pain; Post-operative Care; Post-operative Period; Quadratus Lumborum Block.