Background: The posterior transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) were developed for postoperative pain control after lower abdominal surgery. However, there is little data regarding their effects. Their analgesic effects and the distribution of the cutaneous sensory blockade were observed in patients undergoing laparoscopic gynecologic surgery. Methods: After an induction of general anesthesia, patients alternately received bilateral ultrasound-guided QLB type 2 (QLB2) or posterior TAPB using 20 ml of 0.375% levobupivacaine on each side. The measurements included visual analogue pain scores (VAS), cutaneous sensory blockade in each dermatome, demands for postoperative analgesics, and complications for up to 48 h after the block. Our primary endpoint was VAS at 24 h after the block. Results: Forty patients completed the study. The VAS at rest was significantly lower after QLB2 than that after TAPB at 48 h, but not at 24 h. Neither group differed in VAS when coughing at any point in time. Postoperative demands for fentanyl and other analgesics also did not differ for either block. The majority of injections produced a cutaneous sensory blockade in the T11 and T12 dermatomes in both groups. The median number of dermatomes blocked was limited to three dermatomes after either block. No severe complication related to either block was observed. Conclusions The analgesic effects of QLB2 and posterior TAPB did not differ in patients undergoing laparoscopic gynecologic surgery. The cutaneous sensory blockade produced was limited to three dermatomal levels in the majority of patients. However, these findings need to be confirmed through a larger comparative study.

Objective  Preterm birth is the major cause for neonatal deaths in low and middle income countries. The aim of this report is to evaluate the proportions of deaths of moderate to late preterm infants born at 32 to 36 weeks of gestations as well as the neonates with low birth weights weighing from 1500g to 2499g among the total neonatal deaths and analyze their causes of deaths in Lempira province, the Republic of Honduras. Study design  A secondary analysis based on the data sets from the regional office of Ministry of Health.Methods  We obtained data sets on infant mortality from January 2015 to June 2017 compiled by a regional office of Ministry of Health in Lempira province. We then calculated proportions of each cause of death in the groups of newborn infants stratified by gestational weeks and birth weights.Results  During the study period, a total of 253 neonatal deaths were recorded, comprising 66.9% of the total infant deaths (n=378). The number of the newborn infants who died during early neonatal period was 201 (79.4%). The number of preterm newborn infants who died during neonatal period was 146 (57.7%) and 70 (27.6%) were born at moderate to late preterm periods. 103 (40.7%) were born with their birth-weights below 2500g, and the number of those weighing from 1500g to 2499g were 61 (24.1%). The leading cause of deaths of moderate to late preterm infants was hyaline membrane disease (n=25/48: 52.1%), as was the case with low birth weight infants weighing from 1500g to 2499g. Conclusion  It was shown that approximately one fourths of neonatal deaths occurred in moderate to late preterm infants in Lempira province during the study period. Approximately half of these preterm infants died of hyaline membrane disease, who could have been saved with simple and low-cost equipment such as bubble continuous positive airway pressure.