Quadratus Lumborum Block for Pediatric Hip Surgery

The aim of this prospective randomized study was to compare the analgesic effects between AQLB and CB in children undergoing unilateral open hip reduction/osteotomies for hip dislocation.

Patients were randomly assigned, into 1 of 2 groups, namely, group CB (n = 20) and group AQLB (n = 20).

Preoperatively all children were premedicated by using oral midazolam (0 .5mg/kg).

anesthesia was induced with 3 to 4% sevoflurane and 50% with 60% nitrous oxide in oxygen.Then fentanyl 3 μg/kg and Propofol 1 - 2mg/Kg were administered for anesthesia induction. Airway was secured with endotracheal tube placed in the mouth facilited by 0.15 mg/kg cistracurium. Anesthesia maintenance was performed with sevoflurane 2% in 50% nitrous oxide.

AQLB and CB were done with 1 ml/kg, 0.25% Ropivacaine (maximum dose limited to 20 ml)

Postoperative follow-up:

All patients received 15 mg/kg paracetamol before extubation. Tramadol 2 mg/kg intravenous was planned as rescue analgesia when CHEOPS score was more than 3. Supplemental IV tramado, 1 mg/kg could be added if necessary every 6 hours.

Inclusion criteria

• Patients aged 2 to 7 years old
• Weight ≤ 20 Kg
• American Society of Anesthesiologists (ASA) physical status I or II
• Planned to undergo unilateral open hip reduction/osteotomies

Exclusion criteria

• Cerebral palsy with severe intellectual disability
• Coagulation disorders
• Local or general infection
• Allergy to amide local anesthetics.
• Progressive neurological disorders
• Parenteral refusal
• Spinal dysraphism
• Cutaneous anomalies (angioma, hair truft, naevus or a dimple)near to the puncture