Evaluation of ultrasound-guided continuous anterior quadratus lumborum block on postoperative analgesia in total hip arthroplasty

Abstract

Objective To evaluate the effect of ultrasound-guided continuous anterior quadratus lumborum block (QLB) on postoperative analgesia in total hip arthroplasty. Methods Fifty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 65-80 yr, weighing 45-80 kg, scheduled for elective total hip arthroplasty under subarachnoid block, were divided into 2 groups (n=25 each) using a random number table method: ultrasound-guided continuous anterior quadratus lumborum block group (group Q) and routine analgesia group (group R). Anterior QLB was performed at the end of operation in group Q. Patient-controlled intravenous analgesia was performed with sufentanil after operation in two groups.Dezocine was given as rescue analgesic.Ramsay sedation score and the maximum angle for hip flexion and abduction of hip joint were recorded after operation, and the total consumption of sufentanil, requirement for dezocine and occurrence of adverse reactions were recorded within 72 h after operation.The occurrence of QLB-related complications was also recorded. Results Compared with group R, Ramsay sedation score was significantly decreased and the maximum angle for hip flexion and abduction of hip joint were increased at each time point after operation, and the total consumption of sufentanil, requirement for dezocine and incidence of nausea and vomiting were decreased in group Q (P<0.05). No QLB-related complications were found in group Q. Conclusion Ultrasound-guided continuous anterior QLB can produce better postoperative analgesia and reduce postoperative consumption of opioids with fewer adverse reactions in the patients undergoing total hip arthroplasty. Key words: Ultrasonography; Psoas muscles; Nerve block; Arthroplasty, replacement, hip; Analgesia, patient-controlled