Research Article
Cadaveric Evaluation of Different Approaches for Quadratus Lumborum Blocks
Table 1
Comparison of dye staining between the different needle approaches for QL blocks.
| | Structure | Conventional lateral QL block () | Conventional posterior QL block () | Alternative posterior QL block () | | Deep staining | Faint staining | No staining | Deep staining | Faint staining | No staining | Deep staining | Faint staining | No staining |
| | Thoracolumbar fascia | | | | | | | | | | | Anterior layer | 1 | 1 | 0 | 1 | 1 | 1 | 2 | 2 | 1 | | Middle layer | 2 | 0 | 0 | 3 | 0 | 0 | 5 | 0 | 0 | | Posterior layer | 1 | 1 | 0 | 2 | 0 | 1 | 0 | 1 | 4 |
| | Fascial plane | | | | | | | | | | | EO-IO plane | 1 | 0 | 1 | 0 | 1 | 2 | 0 | 1 | 4 | | IO-TA plane (TAP) | 1 | 1 | 0 | 0 | 2 | 1 | 2 | 3 | 0 | | TF plane | 1 | 0 | 1 | 0 | 0 | 3 | 3 | 1 | 1 |
| | Nerves | | | | | | | | | | | T11 root | 0 | 0 | 2 | 0 | 0 | 3 | 1 | 0 | 4 | | Subcostal (T12) | 2 | 0 | 0 | 1 | 1 | 1 | 4 | 1 | 0 | | Iliohypogastric | 2 | 0 | 0 | 2 | 1 | 0 | 4 | 1 | 0 | | Ilioinguinal | 2 | 0 | 0 | 2 | 1 | 0 | 4 | 1 | 0 | | Genitofemoral | 0 | 0 | 2 | 0 | 0 | 3 | 0 | 0 | 5 | | Lateral femoral cutaneous | 0 | 0 | 2 | 0 | 0 | 3 | 1 | 0 | 4 | | Lumbar plexus | 0 | 0 | 2 | 0 | 0 | 3 | 0 | 0 | 5 |
| | Final extent of dye spread | | | | | | | | | | | Above the arcuate ligament | 0 | 0 | 2 | 0 | 0 | 3 | 0 | 0 | 5 | | Below the iliac crest | 0 | 0 | 2 | 0 | 0 | 3 | 1 | 0 | 4 | | Anterior to the psoas muscle | 0 | 0 | 2 | 0 | 0 | 3 | 0 | 0 | 5 | | Subcutaneous layer | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 5 |
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EO, external oblique muscle; IO, internal oblique muscle; TA, transverse abdominis muscle; TAP, transversus abdominis plane; TF, transversalis fascia.
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