Novel use of combination of electromyography and ultrasound to guide quadratus lumborum block after open appendicectomy.

The quadratus lumborum (QL) block facilitates the administration of anaesthesia to the anterior abdominal wall. The use of ultrasound (US) improves the accuracy of the QL block and reduces the risk of adverse events. Electromyography (EMG) in combination with US for muscle plane blocks has not been described previously.

Excellent postoperative analgesia with the addition of hyaluronidase to lignocaine for subcostal TAP block used in conjunction with systemic analgesia for laparoscopic cholecystectomy.

Subcostal transversus abdominis plane (TAP) blocks provide good postoperative analgesia for laparoscopic cholecystectomies. We hypothesised that adding hyaluronidase may improve the efficacy of this technique by increasing spread of the local anaesthetic (LA). In this case, we performed a bilateral ultrasound-guided subcostal TAP block using lignocaine (40 mL 1%) with hyaluronidase (75 IU/mL) for postoperative analgesia following elective laparoscopic cholecystectomy.