Urinary retention: a possible complication of unilateral continuous quadratus lumborum analgesia – a case report

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DOI: http://dx.doi.org/10.2478/rjaic-2019-0011

Dan Sebastian Dîrzu1, Cosmin Dicu2, Noémi Dîrzu3

1 Department of Anaesthesiology and Intensive Care, University of Medicine and Pharmacy “Iuliu Haţieganu” Cluj-Napoca, Romania
2 Department of Orthopedy, Emergency County Hospital Cluj-Napoca, Romania
3 Research Center for Advanced Medicine Medfuture, University of Medicine and Pharmacy “Iuliu Haţieganu” Cluj-Napoca, Romania

Objective: Continuous quadratus lumborum (QL) analgesia is a new option for proximal femur surgery considered safe and effective. The purpose of this report was to show that we may not be aware of all the possible complications of this technique, and urinary retention may occur even when the block is performed unilaterally.
Case report: To an obese, intubated, mechanically ventilated, female patient, operated in prone position for removal of a femur tumour, we performed a trans-muscular quadratus lumborum block (TQL). We mounted a catheter and administered continuous infusion of local anaesthetic in the postoperative period. The patient experienced urinary retention. A urinary catheter was placed and it was maintained for the entire period of local anaesthetic infusion. When the catheter was removed, 72 hours after the surgery, the patient resumed normal bladder functions.
Conclusion: Urinary retention is a possible complication when continuous quadratus lumborum analgesia is used, even when performed unilaterally.
Keywords: quadratus lumborum block, ultrasound guided regional anaesthesia, urinary retention, toracolumbar plane block, regional anaesthesia complications