• Katrine Tanggaard, Martin Vedel Nielsen, Ulrik Heiner Ullerup Holm, Balthazar Malmkjær Hoffmann, Charlotte Bernhoff, Christian Hs Andersen, Sophia S Thomassen, Christian Hansen, Mette Dam, Troels Dirch Poulsen, HolmPætur MikalPM0000-0001-5205-2644The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved Slagelse and Ringsted Hospitals, Slagelse, Denmark.The Research Unit for Musculoskeletal Function and Physiothe, and Jens Børglum.
• Department of Anesthesiology and Intensive Care Medicine, Zealand University Hospital Roskilde, Roskilde, Denmark.
• Reg Anesth Pain Med. 2024 May 16.

Background And AimsAnterior quadratus lumborum block is a truncal block, applied in close proximity to the lumbar plexus, potentially causing lower limb weakness. This trial aimed to evaluate whether a unilateral anterior quadratus lumborum block caused quadriceps muscle weakness compared with placebo.MethodsIn this randomized, non-inferiority, triple-blind trial, 20 healthy volunteers received an active unilateral anterior quadratus lumborum block with 30 mL ropivacaine 0.75% and a placebo block on the contralateral side. Primary outcome was change in maximal quadriceps muscle strength from baseline to 60 min postblock compared with placebo. Secondary outcomes were change in single-leg 6 m timed hop test, change in Timed-Up and Go test, change in mean arterial pressure from baseline to 30 min postblock and dermatomal affection.ResultsThere was no statistically significant difference in changes in maximal quadriceps muscle strength between active and placebo block; 15.88 N (95% CI -12.19 to +43.94), pnon-inf=0.003, indicating non-inferiority. Timed-Up and Go test was performed significantly faster 60 min postblock; -0.23 s (95% CI -0.38 to -0.08, p=0.005). Mean change in mean arterial pressure from baseline to 30 min postblock was 4.25 mm Hg (95% CI 0.24 to 8.26, p=0.04). Dermatome testing revealed an affection primarily of the lower abdomen (Th10-L1) with the active block.ConclusionIn this randomized controlled trial including healthy volunteers a unilateral anterior quadratus lumborum block does not cause statistical or clinical significant motor block of the quadriceps muscle compared with placebo. When administered correctly, the block can be used for procedures where early postoperative mobilization is essential.Trial Registration NumberNCT05023343.© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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