Ultrasound-Guided Quadratus Lumborum Plain Block versus Fascia Iliaca Block for Postoperative Pain Relief in Patients Undergoing Hip Surgery under Spinal Anesthesia: Randomized Comparative Study.

Document Type : Original research articles

Authors

Anesthesiology, Intensive Care and Pain Medicine Department, Faculty of Medicine, El-Minya University, Minia, Egypt

Abstract

Background: After hip surgery, effective pain management boosts patient satisfaction, enables faster mobilization, reduces the need for pain medications, and improves outcomes.
Objectives: This research compared the analgesic benefits of fascia iliaca block (FIB) to quadratus lumborum block (QLB) performed on individuals scheduled for hip surgery.
Patients and methods: this prospective, randomized, double-blind, controlled study conducted on 60 cases of both sexes, aged from 18 to 70 years old undergoing hip surgery in Minia university hospital. Patients were divided into three groups: group A had a single-shot preoperative QLB, group B received a single-shot preoperative FIB, and group C received no preoperative block at all (Control group). Spinal anesthesia was given to all patients. Our primary finding was the evaluation of the cumulative postoperative analgesic requirement in 24 hours. Our secondary results were the time to the first analgesic request, postoperative VAS, qudricepes power and block-related complications.
Results: in comparison to the FIB group, patients getting a QLB had substantial increase in the first analgesic request time 6.4±2.2 and 6.8±3.2 h respectively (p=0.05*), reduced total opioid needs 8.3±2.4 and 6.7±2.7 mg respectively (p=0.01*), and better qudricepes motor power at 2h (p=0.006*) and considerably lower VAS at 2h (p<0.001*) and 4h (p=0.5*) with no significant side effect.
Conclusion: The use of both QLB and FIB was efficient and safe for postoperative analgesia. Both lowered the score VAS, although QLB had a significantly longer analgesic duration and less opioid consumption than FIB and revealed better quadriceps motor power.

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