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A radiologic and anatomic assessment of injectate spread following transmuscular quadratus lumborum block in cadavers
Author(s) -
Adhikary S. D.,
ElBoghdadly K.,
Nasralah Z.,
Sarwani N.,
Nixon A. M.,
Chin K. J.
Publication year - 2017
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13647
Subject(s) - medicine , cadaver , anatomy , lumbar plexus , dissection (medical) , lumbar , lumbosacral plexus , anterior superior iliac spine , iodinated contrast , radiology , computed tomography
Summary We performed bilateral transmuscular quadratus lumborum blocks in six cadavers using iodinated contrast and methylene blue. Computed tomography imaging was performed in four cadavers and anatomical dissection was completed in five. This demonstrated spread to the lumbar paravertebral space in 63% of specimens, laterally to the transversus abdominis muscle in 50% and caudally to the anterior superior iliac spine in 63% of specimens. There was no radiographic evidence of spread to the thoracic paravertebral space. Anatomical dissection revealed dye staining of the upper branches of the lumbar plexus and the psoas major muscle in 70% of specimens. Further clinical studies are required to confirm if the quadratus lumborum block might be a suitable alternative to lumbar plexus block.