PMC6942774_01
Patient with "J" incision and right-sided quadratus lumborum catheter. Left-sided catheter not shown in figure.
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fig1
After closure of the right abdominal "J" incision and prior to emergence, ultrasound-guided QLC were placed bilaterally (Figure 1).
Placement of linear ultrasound transducer on the posterior aspect to allow visualization of posterior aponeurosis of the transversus abdominis muscle.
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fig2
A linear ultrasound transducer was placed in the anterior axillary line and moved posteriorly until the posterior aponeurosis of the transversus abdominis muscle became visible (Figure 2).
Ultrasound image obtained to place nerve catheters. EO = external oblique muscle. IO = internal oblique muscle. TA = transversus abdominis muscle. Yellow line depicts trajectory of needle into posterior aponeurosis of transversus abdominis muscle.
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fig3
Tuohy needle was utilized to thread a nerve catheter into the fascial plane. The Tuohy was inserted from the anterior end of the transducer and advanced until this aponeurosis was penetrated (Figure 3).