Quadratus lumborum (QL) block: Anterior approach

In this video we discuss the anterior approach to the quadratus lumborum block (also known as QL3, or the transmuscular QL block), including the anatomy, sonoanatomy, technique and tips and tricks for success.

[@gusshidyak8770]

Your videos are the best! Because of the clarity of the presentation, I’ve been confident to attempt many new blocks that were too abstract to learn from a video and I have a very good block success rate and so far no complications! Thank you! Your fellows and residents are lucky to have you!

[@MegaPoliyo]

I'm in the UK i'd literally love to come and do a regional fellowship with this guy. We are ahead of a lot of parts of the world with anaesthesia training (takes 7 years so go figure) but regional still feels nascent and evolving and as such isnt built into the core curricula

[@57precision]

Thanks for the great video. I recognize that this is superior to a TAP but I am struggling with the speed of this in a busy OR. Oftentimes with a good tech I can get bilateral TAPs in by the time the CRNA is done taping the tube, and can extend with rectus sheath if needed.
With this it seems you need to flip flop around and prep twice. I would love to hear some efficiency tips if you have any.

[@user-kh8xw2vw7z]

Thank you very much, this is amazing 👏

[@adziuba12]

This is fantastic. Thank you!

[@regionalanesthesiology]

Thank YOU for watching!

[@JohnDoe-ie1vi]

Need more people so spread this video more

[@user-zh3cq8sz5j]

Your videos is very good 🎉
Thanks.
Can you make like that discussion about Single-shot of spinal anesthesia?

[@urvashikashyap657]

Sir at which level did you keep the probe? Is it the L4 level?

[@uramalakia]

Why do you prefer the anterior approach over the posterior one?

[@user-ze7dl1gb3j]

「明確なメッセージ、明確な構造、理解しやすい、ありがとう」、

[@doctorbius]

How do u block the other side without flipping over

[@user-we7df3go5v]

Would this be effective for anaelgesia after opened kidney resection?

[@MrGaviriajuan]

This dscription is QL3 o transmuscular approach

[@oceandiscovery5288]

Question: Are you suggesting that you can do a bilateral anterior QL block in the lateral position without flipping to the other side? I guess I need help visualizing this being done bilaterally in the lateral position

[@fokoracer1]

I have the same question.... he implies that in the narrative but not sure how it would be done

[@oceandiscovery5288]

Second Question: We currently use TAP blocks for our colorectal ERAS protocol…would you recommend this block as a more superior alternative to the TAP for post-op analgesia?

[@spjm11]

Definitely superior for at least 2 reasons. Midaxillary TAP blocks won’t cover above T10 (umbilicus) so any incision or port sites above this don’t get covered. TAP blocks also only block the abdominal wall whereas QL will give you visceral coverage = better block.

[@erickim1830]

If you're looking for supra umbilical somatic abdominal wall coverage, can consider supra umbilical rectus sheath vs subcostal TAP vs external oblique intercostal (EOI); any of these can be paired with supine lateral TAP after calculating for max LA dose.

[@basmagaber4984]

Top fan

[@regionalanesthesiology]

Thanks so much for watching!

[@tuanquoc6188]

the video image is too poor, you need to fix it more

[@nerveblock]

It's phenomenal for QL blocks. They don't need to fix anything, you need to learn more.

[@gusshidyak8770]

@@nerveblock Good answer!