Evaluation of regional Quadratus Lumborum block in a pediatric population using 7 Tesla MRI - an anatomical study

• Grant number: 24/07012-9
• Support Opportunities: Regular Research Grants
• Start date: May 01, 2025
• End date: April 30, 2027
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Vinícius Caldeira Quintão
• Grantee: Vinícius Caldeira Quintão
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Maria José Carvalho Carmona

Abstract

Introduction Pediatric regional anesthesia has gained prominence due to the increasing adoption of opioid-sparing strategies and growing concerns about the potential adverse effects of general anesthetics on neurodevelopment. However, conducting regional anesthesia studies in pediatric populations presents challenges, leading to a scarcity of evidence specific to this group. The lack of pediatric studies often results in clinical practices based on the extrapolation of findings from adult studies. The spread of the anesthetic solution after performing an interfascial block is critical for determining the extent of its effect. The Quadratus Lumborum block is commonly performed in pediatric patients, especially in urological and lower abdominal surgeries; however, there are few anatomical studies on this subject in the studied population. Objectives The study aims to evaluate the spread of the anesthetic solution injected during the Quadratus Lumborum block, using 7 Tesla magnetic resonance imaging, in pediatric cadavers from the preschool population. Methods An anatomical study will be conducted with 24 pediatric cadavers, aged 2 to 6 years, referred to the Mortality Verification Service over a two-year data collection period. The ultrasound-guided block will be performed in the Imaging Platform of the Autopsy Room (PISA), using a specific peripheral block needle and an anesthetic solution consisting of a local anesthetic and gadolinium, with a volume of 0.4 ml/kg. One hour after the block, the cadavers will be transferred to the adjacent PISA room for 7 Tesla magnetic resonance imaging, followed by an analysis of the spread of the injected solution. (AU)