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CASE REPORT
Year : 2019  |  Volume : 63  |  Issue : 8  |  Page : 667-670

A radiological inquest to determine the destiny of ultrasound guided trans-muscular quadratus lumborum plane catheters


1 Department of Anaesthesiology, Sancheti Hospital, Pune, Maharashtra, India
2 Department of Anaesthesiology, Dr. Hedgewar Hospital, Aurangabad, Maharashtra, India
3 Department of Surgery, Dr. Hedgewar Hospital, Aurangabad, Maharashtra, India
4 Department of Anaesthesiology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

Correspondence Address:
Dr. Sandeep Diwan
Department of Anaesthesiology, Sancheti Hospital, Pune - 411 005, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_333_19

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After a quadratus lumborum (QL) block, the course of QL plane catheter is unpredictable. This case series discusses the course and fate of trans-muscular QL catheters by following and discussing the contrast spread through the fascial planes. Intrao-peratively, the catheters were tracked by the surgeons and were checked for integrity of anterior thoracolumbar fascia (ATLF) by injecting sterile 0.9% saline. The ATLF was intact upon injection and there was cephalad and medial saline spread with slight bulging of ATLF. On day 3 after written informed consent from all patients, computed tomography (CT) contrast studies were performed. Post-operative contrast spread was variable and was visualised in transversus abdominis plane, QL plane, lower thoracic paravertebral space, inter-vertebral foramina and anterior epidural space. CT contrast images demonstrated a variable spread. In conclusion, injection in ATLF of QL can spread along the path of least resistance and is unpredictable.


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