Portal de Periódicos da CAPES

Bloqueio do quadrado lombar tipo II para uma gastrectomia subtotal em um paciente séptico

2016; Elsevier BV; Volume: 68; Issue: 2 Linguagem: Inglês

10.1016/j.bjan.2016.09.009

1806-907X

José Miguel Cardoso, Miguel Sá, Hugo Reis, Liliana Almeida, José Carlos Sampaio, Célia Pinheiro, Duarte Machado,

Spine and Intervertebral Disc Pathology

Quadratus Lumborum block was recently described and has already shown good results as an analgesic technique in abdominal surgeries, having the potential to significantly reduce opioids consumption and be a valid alternative to epidural catheter. We performed a type II Quadratus Lumborum block for analgesia in a septic patient having a sub-total gastrectomy.An 80 year-old, ASA III, male patient, weighting 50kg, with a history of arterial hypertension and hypercholesterolemia, diagnosed with sepsis due to purulent peritonitis was submitted to an open laparotomy. Bilateral ultrasound-guided type II Quadratus Lumborum block was performed before surgery, using 10mL of levobupivacaine 0.25% and 5mL of mepivacaine 1%, per side. Pain relief was achieved 5minutes after injection and the patient referred no pain in the immediate postoperative period.Type II Quadratus Lumborum block may be considered a valid alternative for postoperative analgesia in a septic patient undergoing major abdominal surgery with some relative contraindications to epidural catheter placement. It allowed us to achieve excellent pain management avoiding opioids usage. However, more reports are still needed to properly access its usefulness.