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50th Annual Regional Anesthesiology and Acute Pain Medicine Meeting
May 1 - 3, 2025 | Orlando, Florida
6591
QUADRATUS LUMBORUM BLOCK WITH LIPOSOMAL BUPIVACAINE FOR KIDNEY TRANSPLANTATION IN TWO PEDIATRIC PATIENTS
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Medically Challenging Cases
Quadratus Lumborum Block with Liposomal Bupivacaine for Kidney Transplantation in Two Pediatric Patients
Introduction
-Adequate pain control is crucial for pediatric transplant recipients' overall well-being and comfort. It alleviates suffering, promotes earlier mobilization and improves respiratory function.
-Quadratus lumborum (QL) blocks provide effective analgesia in kidney transplant surgeries.
-There are few prior studies of using liposomal bupivacaine (LB) for QL blocks, especially in pediatric patients.
-We report the use of LB in a QL block for two patients who underwent kidney transplant surgery.
Methods
-This case report falls under the scope of an approved IRB protocol at the University of Pittsburgh.
-Use of liposomal bupivacaine (EXPAREL, Pacira BioSciences, Inc.) was approved by the surgeon and pharmacy leadership. Patients’ guardians provided written consent for its use.
-Data was gathered from the electronic medical records, including daily progress notes, nursing flow sheets, and medication administration records.
Discussion
-For our patients, anterior approach quadratus lumborum blocks with liposomal bupivacaine provided effective and sustained pain relief with minimal opioid administration and improved our patients’ recovery outcomes.
-A recently published meta-analysis found no clinical superiority for using LB in abdominal fascial plane blocks compared to plain bupivacaine. Of note, there was only one QL block study, which used a lateral approach, included.
-Further studies are required to better understand the efficacy and safety of liposomal bupivacaine in kidney transplant recipients receiving QL blocks.