Abstract
Quadratus lumborum block (QL) is a relatively new regional anesthesia technique that has been used in different surgeries for improved outcomes. There are few case reports and studies about its role in total hip arthroplasty with variable effects. This study aimed to evaluate the effect of QL block on postoperative pain control, opioid consumption, and the incidence of postoperative adverse events in total hip arthroplasty surgeries.A systematic review of the scientific literature addressing the use of QL block in hip arthroplasty was performed following the PRISMA guidelines and using the online database databases, Medline and Science Direct. We registered this review with the PROSPERO database in May 2021 (reference number-CRD42021247055). Two authors performed the literature searches in June 2021 and repeated them in July 2021 to ensure accuracy. Review Manager software (RevMan for Mac, version 5.4; Cochrane Collaboration, Oxford, United Kingdom) was used to perform a meta-analysis of studies included in our review. Five randomized controlled trials were identified for inclusion (n=394) in our meta-analysis.The results demonstrated a beneficial effect of QL block in pain control at 6, 12, and 24 hours postoperatively after hip arthroplasty (p <0.05). Opioid consumption for 24 hours was significantly reduced in the QL group (p=0.010). Our study also demonstrated that QL block is associated with a significant reduction in postoperative nausea and vomiting (PONV) (p=0.04). In conclusion, QL block can provide significantly better pain control after total hip arthroplasty at 6, 12, and 24 hours postoperatively. It also results in significantly reduced 24 hour-opioid consumption. This block is also associated with a lesser incidence of PONV and a better satisfaction level postoperatively.
Highlights
BackgroundTotal hip arthroplasty surgery is usually associated with significant postoperative pain
The results demonstrated a beneficial effect of Quadratus lumborum block (QL) block in pain control at 6, 12, and 24 hours postoperatively after hip arthroplasty (p
Our study demonstrated that QL block is associated with a significant reduction in postoperative nausea and vomiting (PONV) (p=0.04)
Summary
BackgroundTotal hip arthroplasty surgery is usually associated with significant postoperative pain. Adequate control of pain helps in earlier mobilization and improves patient comfort. Both multimodal systemic analgesia using opioids and various regional anesthesia techniques have been shown to improve pain control and opioid consumption [1,2,3,4]. Both of these techniques have their own pros and cons. The study hypothesized that QL block is associated with significant improvements in postoperative nausea, vomiting, pain control, and opioid consumption after hip arthroplasty. Important changes to methods after trial commencement (such as eligibility criteria), with reasons
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