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Combining transmuscular quadratus
lumborum block and local infiltration analgesia can be recommended as the
primary method for enhanced recovery in total hip arthroplasty patients.
In people with total hip arthroplasty (THA) via a posterolateral approach, the combination of transmuscular quadratus lumborum block (QLB) and local infiltration analgesia (LIA) can offer better post-surgery pain relief in comparison with treatment with LIA alone. This trial was carried out to investigate the efficacy of ultrasound-guided transmuscular QLB and LIA for pain management and recovery in 80 people with American Society of Anesthesiology functional status scores of II-III and undergoing THA.
In this prospective randomized controlled trial, the recruited subjects were randomized to either the control group (group C) or the nerve block group (group N). People in group N were given transmuscular QLB combined with LIA, while people in group C were given only LIA.
The major endpoint was post-surgery pain during the initial active motion (estimated at 6 hours following operation and evaluated utilizing a visual analog scale [VAS]). VAS scores during motion at 12, 24, 48, and 72 hours following operation; resting VAS pain scores in post-anesthesia care unit (PACU) and at two, six, 12, 24, 48, and 72 hours following surgery; frequency of sleep disturbance due to pain on the night of operation; intraoperative intake of opioids; post-surgery intake of morphine hydrochloride; time until the first "walk out of the bed" following operation; muscle strength of quadriceps femoris; and post-surgery side effects were the secondary endpoints.
In comparison with group C, group N exhibited considerably reduced VAS scores during motion at six, 12, and 24 h following THA, as well as decreased resting VAS scores in the PACU and at two, six, 12, and 24 h following THA. As found, Group N consumed substantially smaller amounts of intraoperative opioids and morphine following the operation.
Group N witnessed substantially
less disturbance in sleep due to pain on the night of operation and could
"walk out of the bed" earlier when compared to group C. No vital
differences were noted between the
groups in muscle strength of quadriceps femoris or the occurrence of
post-surgery side effects.
The combination of transmuscular
QLB with LIA does not cause weakness of quadriceps femoris muscle and is linked
with a considerably minimized requirement for intraoperative opioids and thus
can also improve the recovery of people who have undergone THA.
The Journal of Clinical Anesthesia
The impact of ultrasound-guided transmuscular quadratus lumborum block combined with local infiltration analgesia for arthroplasty on postoperative pain relief
Jian Hu et al.
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