Bloqueio do quadrado lombar (QL - Block) para ováriohisterectomia em cadela - relato de caso.

Abstract

New discoveries are encouraging in pharmacology, patient monitoring and anesthesia techniques, ensuring better quality and patient safety. Among the anesthetic modalities, locoregional anesthesia is becoming increasingly important in pain management, not only for patient comfort, but also for reducing the use of general anesthetics and opioids. As a result, the quadratus lumborum block (QL block) has become an excellent choice for locoregional anesthesia for abdominal surgeries. With the help of ultrasound, anesthesiologists can more accurately recognize anatomical structures and, as a result, the success rate of anesthesia increases. The block is performed on the medial fascia of the quadratus lumborum muscle and the lateral fascia of the psoas minor muscle, blocking the skin, muscles and abdominal parietal peritoneum. The aim of this report was to describe the technique and show the benefits of performing ultrasound-guided QL block in small animals. This article reports the case of a 4-year-old female dog, mixed breed, weighing 17.9 kg, anesthetized to perform an elective ovariohysterectomy. After general anesthesia, the animal was positioned in lateral decubitus and, with the aid of a linear transducer positioned between the caudal edge of the last rib and the transverse process of L2, it was guided to the quadratus lumborum (QL) muscle, the psoas minor muscle and their respective muscle fasciae. The local anesthetic was then directed to the interfascial space between the quadratus lumborum and psoas minor muscles. 5.3 mL of 0.25% bupivacaine (0.3 mL/kg/point) were administered, totaling 10.6 mL at the two application points. During the surgery, the animal presented normal heart (130 bpm) and respiratory (16 mpm) rates and systolic (118 mmHg), mean (79 mmHg) and diastolic (68 mmHg) blood pressure. There was slight hypothermia (37.1 °C), but with the use of a thermal mattress the patient recovered quickly after the end of the procedure. It is concluded that the quadratus lumborum block (QL-Block) proved to be an excellent option for intraoperative analgesia when used for ovariohysterectomy surgery.