1. Quadratus Lumborum Block as a Cornerstone for Neonatal Intestinal Surgery Enhanced Recovery (ERAS): A Case Series
- Author
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Hoffmann,Cassandra, Snow,Angela, Chedid,Celine, Abi Shadid,Carol, Miyasaka,Eiichi, Hoffmann,Cassandra, Snow,Angela, Chedid,Celine, Abi Shadid,Carol, and Miyasaka,Eiichi
- Abstract
Cassandra Hoffmann,1 Angela Snow,2 Celine Chedid,3 Carol Abi Shadid,3 Eiichi A Miyasaka4 1Pediatric Anesthesiology, Akron Childrenâs Hospital, Akron, OH, USA; 2Pediatric Anesthesiology, Nemours Childrenâs Hospital, Wilmington, DE, USA; 3Pediatric Anesthesiology, University Hospitals Rainbow Babies and Childrenâs Hospital, Cleveland, OH, USA; 4Pediatric Surgery, University Hospitals Rainbow Babies and Childrenâs Hospital, Cleveland, OH, USACorrespondence: Eiichi A Miyasaka, Pediatric Surgery, University Hospitals Rainbow Babies and Childrenâs Hospital, 11100 Euclid Ave, MAC 1000, Cleveland, OH, 44106, USA, Tel +1 216-844-3015, Fax +1 216-844-8647, Email eiichi.miyasaka@uhhospitals.orgPurpose: Neonates present unique challenges for pediatric surgical teams. To optimize outcomes, it is imperative to standardize perioperative care by using early extubation and multimodal analgesic techniques. The quadratus lumborum (QL) block provides longer duration and superior pain relief than other single-injection abdominal fascial plane techniques. The purpose of this case series was to report our initial experience with QL blocks in neonatal patients treated with intestinal ERAS.Patients and Methods: Ten neonates requiring intestinal surgery at a single tertiary care center who received QL blocks between December 2019 and April 2022 for enhanced recovery were studied. Bilateral QL blocks were performed with 0.5 mL/kg of 0.25% ropivacaine per side with an adjuvant of 1 mcg/kg of dexmedetomidine.Results: Gestational age at birth ranged from 32.2 to 41 weeks. The median age, weight, and American Society of Anesthesiologists (ASA) score at the time of surgery was 5 days [range 7.5 hours, 60 days], 2.84 kg [range 1.5, 4.5], and 3, respectively. Bilateral QL blocks were performed without complications in all patients. Two patients were outside the neonatal range from birth to surgery, but were under 42 weeks gestational age when corrected for prematurity. All patients were ex
- Published
- 2023