Ultrasound-guided quadratus lumborum block for postoperative analgesia in a pediatric patient with congenital hip dislocation: a case report.

Developmental dysplasia of the hip (DDH) is a common congenital pediatric orthopedic malformation that often requires open reduction combined with pelvic osteotomy, resulting in severe postoperative pain. Pediatric patients under 2 years old have immature anatomical and physiological characteristics, high sensitivity to opioid analgesics, and an inability to subjectively express pain, which makes perioperative analgesia and anesthesia management a major clinical challenge. Traditional opioid-based analgesic regimens carry a high risk of adverse reactions such as respiratory depression and restlessness, which hinder postoperative recovery. This case reports the optimized perioperative anesthesia and analgesia management strategy for a 19-month-old female infant (12 kg, ASA Ⅰ) with right DDH undergoing open hip reduction and pelvic osteotomy, and preliminarily explores the clinical application value, efficacy and safety of ultrasound-guided type Ⅱ QLB in infant DDH surgery. A composite anesthesia strategy of general anesthesia combined with ultrasound-guided type Ⅱ QLB (0.2% ropivacaine, 0.5 mL/kg, total 6 mL) was adopted, with optimized perioperative management including precise airway selection, targeted vital sign monitoring, and multimodal postoperative analgesia (PCIA+on-demand oral acetaminophen). Pain was evaluated using the FLACC behavioral scale, and vital signs and adverse reactions were closely monitored postoperatively. The infant's 24-hour postoperative FLACC scores were all ≤2 points without the need for rescue analgesics, with significantly reduced opioid consumption (intraoperative sufentanil 6