Figure 1.

(a) Trans-muscular Quadratus Lumborum block. The Shamrock method depicting the QL (Quadratus Lumborum), PMa (Psoas Major), TAP (Tranversus Abdominis Plane), needle through the QL muscle. (b) The tense and bulging ATLF: axial Plane at Lumbar level, ATLF – Anterior Thoracolumbar Fascia; PMa Psoas Major; TAP – Transversus Abdominis Plane; QL Quadratus Lumborum; ES Erector Spinae. The red arrow above QL muscle shows the location of ilio-hypogastric vessels which can get punctured during needle placement. (c) The perinephric spread across the PTLF (Axial plane) at Thoracic level; Pma–Psoas Major; QLQuadratus Lumborum; SCSpinal Cord; ES–Erector Spinae; TAP-Transversus Abdominis Plane. (d) Sagittal plane: Contrast extends along the entire length of the QLP. (ES – Erector Spinae; QL – Quadratus Lumborum)