The decrease in quadriceps strength after anterior quadratus lumborum block (AQLB) has not been quantified. This prospective cohort study investigated the incidence of quadriceps weakness after AQLB. We enrolled patients undergoing robot-assisted partial nephrectomy, and AQLB was performed at the L2 level with 30 mL of 0.375% ropivacaine. We evaluated each quadriceps' maximal voluntary isometric contraction using a handheld dynamometer preoperatively and postoperatively at 1 and 4 days. The incidence of muscle weakness was defined as a 25% reduction in muscle strength compared with the preoperative baseline, and "muscle weakness possibly caused by nerve block" was defined as a 25% reduction compared with the non-block side. We also assessed the numerical rating scale and quality of recovery-15 scores. Thirty participants were analyzed. The incidence of muscle weakness compared with preoperative baseline and the non-block side was 13.3% and 30.0%, respectively. Patients with a numerical rating scale ≥ 4 or quality of recovery-15 score < 122, which was classified as moderate or poor, had decreased muscle strength with relative risks of 1.75 and 2.33, respectively. All patients ambulated within 24 h after surgery. The incidence of quadriceps weakness possibly caused by nerve block was 13.3%; however, all patients could ambulate after 1 day.
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http://dx.doi.org/10.3390/jcm12113837 | DOI Listing |
Quant Imaging Med Surg
January 2025
Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Background: Quantitative ultrasound imaging is a popular technique to assess the structural properties of the intrinsic and extrinsic foot muscles. Although several studies examined test-retest reliability, specific gaps remain in assessing inter-rater reliability, particularly distinguishing between image acquisition and muscle measurement. Additionally, these studies utilized equipment that may not be generalizable across both clinical and research settings and often involved small sample sizes without prior sample size calculations.
View Article and Find Full Text PDFJ Anesth
January 2025
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Purpose: To examine the ramifications of both the modified and traditional subcostal anterior quadratus lumborum block (SQLB) on postoperative analgesia in individuals undergoing laparoscopic nephrectomy.
Methods: Forty-six individuals slated for elective laparoscopic nephrectomy under general anesthesia were randomly assigned to acquire either traditional or modified SQLB using 20 mL of 0.5% ropivacaine.
Plast Reconstr Surg Glob Open
January 2025
From the Division of Plastic Surgery, Mayo Clinic, Phoenix, AZ.
Background: Vertebral body defects pose a significant challenge in spinal reconstructive surgery. Compression fractures of the vertebral corpus are typically treated with vertebral augmentation procedures. There are significant risks associated with the introduction of foreign material in the spine, including infection and pseudarthrosis.
View Article and Find Full Text PDFJ Neurol
January 2025
Department of Neurology and Neurosciences, Donostia University Hospital, Biogipuzkoa Health Research Institute, Donostia-San Sebastián, Spain.
Background: Alpha-actinin-2, a protein with high expression in cardiac and skeletal muscle, is located in the Z-disc and plays a key role in sarcomere stability. Mutations in ACTN2 have been associated with both hypertrophic and dilated cardiomyopathy and, more recently, with skeletal myopathy.
Methods: Genetic, clinical, and muscle imaging data were collected from 37 patients with an autosomal dominant ACTN2 myopathy belonging to 11 families from Spain and Belgium.
J Med Ultrasound
April 2024
Department of Anesthesiology, The School of Clinical Medicine, Fujian Madical University, The First Hospital of Putian City, Fujian, China.
Background: To test the novel ultrasound (US)-guided bilateral anterior quadratus lumborum block (QLBA) at the lateral supra-arcuate ligament (supra-LAL) technique combined with postoperative intravenous analgesia was a viable alternative approach of conventional thoracic epidural analgesia (TEA) for laparoscopic radical gastrectomy (LRG).
Methods: Three hundred and four patients scheduled for LRG were randomized 1:1 into QLBA group: receiving a novel pathway of US-guided bilateral QLBA at the supra-LAL before general anesthesia (GA) and patient-controlled intravenous analgesia (PCIA) after surgery, and TEA group: receiving TEA before GA and patient-controlled epidural analgesia following surgery. The difference in procedure time between the treatment groups was set as the primary endpoint.
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