<![CDATA[Background: Postoperative pain control after kidney transplantation is important because inadequate analgesia may delay recovery and increase opioid-related adverse effects. Analgesic options in patients with end-stage renal disease (ESRD) are limited, making opioid-sparing multimodal strategies especially relevan. Quadratus lumborum block (QLB) has been studied as part of multimodal analgesia in renal surgery, but evidence on continuous QLB in adult kidney transplant recipients is still limited. Case: We report a retrospective case series of 3 adult kidney transplant recipients who received general anesthesia combined with bilateral ultrasound-guided continuous QLB as part of perioperative analgesia. In all cases, QLB was performed with bupivacaine 0.25% 10 mL on each side, followed by intraoperative top-up dosing. Postoperative analgesia was standardized with continuous QLB infusion using bupivacaine 0.1% at 6 mL/hour, intravenous paracetamol 1000 mg every 8 hours, and fentanyl patient-controlled analgesia on demand. Postoperative pain was assessed using the Numeric Rating Scale (NRS) over 72 hours. In 2 patients, postoperative pain remained mild, with NRS scores ranging from 0 to 2 throughout the observation period and no rescue analgesia required. In 1 patient, pain briefly peaked at NRS 4 at 3 hours after surgery and was controlled with a single fentanyl PCA bolus, with subsequent pain scores remaining between 0 and 2. No block-related or analgesia-related complications were observed. Conclusion: Continuous bilateral QLB may be a feasible opioid-sparing component of multimodal postoperative analgesia in adult kidney transplant recipients. Larger prospective studies are needed to confirm its effectiveness and define its role in kidney transplantation.]]>
