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, Serkan Tulgar, MD Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital , Samsun, 55020, Turkey Search for other works by this author on: Oxford Academic Bahadir Ciftci, MD Department of Anesthesiology and Reanimation, Istanbul Medipol University , Istanbul, 34000, Turkey Department of Anatomy, Istanbul Medipol University , Istanbul, 34000, Turkey Corresponding author: Department of Anesthesiology and Reanimation, Istanbul Medipol University, School of Medicine, Mega Medipol University Hospital, 34040 Bagcilar, Istanbul, Turkey. Email: Bciftci@medipol.edu.tr; baha_cftci@hotmail.com. Search for other works by this author on: Oxford Academic Ali Ahiskalioglu, MD Department of Anesthesiology and Reanimation, Development and Design Application and Research Center, Ataturk University School of Medicine , Erzurum, 25030, Turkey Search for other works by this author on: Oxford Academic Bora Bilal, MD Faculty of Medicine, Department of Anesthesiology and Reanimation, Kahramanmaras Sutcu Imam University , Kahramanmaras, 46000, Turkey Search for other works by this author on: Oxford Academic Bayram Uf*ck Sakul, MD Department of Anatomy, Istanbul Medipol University , Istanbul, 34000, Turkey Search for other works by this author on: Oxford Academic Melike Girit, MSc Department of Anatomy, Istanbul Medipol University , Istanbul, 34000, Turkey Search for other works by this author on: Oxford Academic Tugce Akin, MSc Department of Anatomy, Istanbul Medipol University , Istanbul, 34000, Turkey Search for other works by this author on: Oxford Academic Madan Narayanan, MD Consultant-Anaesthetics and Intensive Care, Frimley Park Hospital NHS Foundation Trust , Camberley, GU14 8HT, United Kingdom Search for other works by this author on: Oxford Academic Haci Ahmet Alici, MD Department of Pain Medicine, Istanbul Medipol University , Istanbul, 34000, Turkey Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0002-3245-6614 Pain Medicine, Volume 25, Issue 6, June 2024, Pages 370–373, https://doi.org/10.1093/pm/pnae018
Published:
08 March 2024
Article history
Received:
01 January 2024
Accepted:
09 February 2024
Published:
08 March 2024
Corrected and typeset:
12 April 2024
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Serkan Tulgar, Bahadir Ciftci, Ali Ahiskalioglu, Bora Bilal, Bayram Uf*ck Sakul, Melike Girit, Tugce Akin, Madan Narayanan, Haci Ahmet Alici, Ultrasound guided quadro-iliac plane block: another novel fascial plane block, Pain Medicine, Volume 25, Issue 6, June 2024, Pages 370–373, https://doi.org/10.1093/pm/pnae018
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Abstract
Study objective
We report a novel block technique aimed to provide lumbosacral, abdominal, and hip analgesia: The quadro-iliac plane (QIP) block.
Design
A cadaveric examination that evaluates the spread of QIP block.
Setting
Cadaver laboratory.
Patients
One unembalmed cadaver.
Interventions
Bilateral ultrasound-guided QIP blocks on cadavers with 40 mL of methylene blue %0.5 each side.
Measurements
Dye spread in cadaver.
Main results
There was staining in the deep interfascial plane of the erector spinae muscles. Extensive staining of the interfascial plane corresponding to the posterior aspect of the quadratus lumborum muscle (QLM) was observed. There was extensive staining on the anterior surface of the QLM. There was spread of dye traversing along the transversalis fascia and significantly infiltrating retroperitoneal fat tissue. Bilateral staining of the ilioinguinal and iliohypogastric nerves was observed. On the right, there was minimal staining over the subcostal nerve. There was dye present bilaterally within the deep regions of the transverse processes. The lumbar plexus was stained on both sides.
Conclusion
The local anesthetic applied from a place where the QLM reaches its largest volume and the fascial plane creates a closed gap in the caudal area may exhibit a more rounded and extensive spread.
Quadro-iliac plane block, involves the administration of local anesthetic to the posterior aspect of the QLM at its origin from the iliac crest. According to our cadaver study, this technique may be a promising option for alleviating acute and chronic pain in the lumbosacral, lower abdominal, and hip regions.
Quadro-iliac plane block, lumbosacral analgesia, abdominal analgesia, hip analgesia, interfascial plane block, cadaveric study
© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
Topic:
- ultrasonography
- anesthesia, local
- anesthetics, local
- cadaver
- dyes
- hip region
- hip joint
- ilium
- abdomen
- pain management
- analgesia (pain absence)
- fascia
- lumbar plexus
- iliac crest
- spinal erector muscles
- quadratus lumborum muscle
Issue Section:
> Technical Note
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