Quadratus lumborum block provides improved immediate postoperative analgesia and decreased opioid use compared with a multimodal pain regimen following hip arthroscopy.

Abstract

ABSTRACTThe purpose of our study was to evaluate the effect on immediate patient outcomes following hip arthroscopy with use of a preoperative, single shot quadratus lumborum (QL) block. We retrospectively reviewed patients who underwent hip arthroscopy following a preoperative QL block. These patients were matched by age and gender to patients who had not received a block. Visual analogue scale (VAS) pain scores immediately postoperatively and at the time of discharge were recorded. Hourly and overall opioid intake in the postanesthesia care unit (PACU) was also recorded. Continuous data was analysed with paired t-test, with significance being defined as P < 0.05. Complications in the immediate postoperative period were recorded, as was time from admission to PACU to discharge. Fifty-six patients were included. Twenty-eight patients underwent QL block and 28 did not undergo a block. QL block patients required significantly less hydromorphone (P = 0.010) and oxycodone (P = 0.001) during their time in the PACU, and significantly fewer morphine equivalents overall and per hour in the PACU (P < 0.001). Despite receiving less opioid analgesia, QL block patients had significantly less pain immediately postoperatively (P = 0.026) and at the time of discharge (P = 0.015). The mean time to PACU discharge was 155 ± 49 min, and there was no difference in time to discharge between groups (P = 0.295). One patient in the QL block group experienced persistent flank numbness. Hip arthroscopy patients who received a preoperative QL block had less pain and a lower opioid requirement in PACU than those who did not receive a block. Level of Evidence: Level III (Retrospective matched cohort study).