scholarly journals Postoperative Pain Treatment with Transmuscular Quadratus Lumborum Block and Fascia Iliaca Compartment Block in Patients Undergoing Total Hip Arthroplasty: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Qin Xia ◽  
Wenping Ding ◽  
Chao Lin ◽  
Jiayi Xia ◽  
Yahui Xu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Total Hip Arthroplasty ◽  
Elderly Patients ◽  
Hip Arthroplasty ◽  
Controlled Study ◽  
Total Hip ◽  
Randomized Controlled ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Fascia Iliaca Compartment Block

Abstract Background: Patients after total hip arthroplasty (THA) often suffered moderate or even severe pain, seriously affecting the early postoperative recovery. This study aimed to investigate the analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block (T-QLB) combined with fascia iliaca compartment block (FICB) for elderly patients undergoing THA.Methods: Sixty-four patients scheduled for THA were included in this randomized controlled study. The patients were divided into two groups: group Q and group QF. Before anesthesia induction, group Q was injected with 0.375% ropivacaine 40ml. In the QF group, T-QLB combined with FICB was injected with 0.375% ropivacaine 20ml, respectively. Paracetamol 1g regularly at 6 h intervals and patient-controlled intravenous analgesia (PCIA) were administrated in both groups postoperatively. The primary outcome was cumulative sufentanil consumption via PCIA on postoperative 24 h. The secondary outcomes included pain degree, time to the first analgesic requirement, range of motion, quality of recovery, and the incidence of postoperative complications.Results: Compared with the group Q, the cumulative sufentanil consumption were significantly lower in group QF at 6-12, 12-18, 18-24, and 24h (49.29±16.76 vs. 31.42±18.81μg, P <0.001) after surgery. The postoperative pain intensity was lower in group QF at rest after 6, 12, and 24 h (P <0.05) and at activity after 6, 12, 18, and 24 h (P <0.05). Group QF had higher Qor-15 scores at postoperative 24 h and 48 h (P <0.001) and longer duration before the first opioid require via PCIA (P <0.001) postoperatively than group Q. There was no statistically significant difference between the two groups for complications postoperatively of elderly.Conclusions: Our study provides a multimodal, opioid-sparing analgesic regimen for elderly patients in THA. The combination of T-QLB and FICB provides a significant advantage for early postoperative functional recovery. Further studies are required to confirm the minimum effective dose.Trial registration: Chinese Clinical Trial Registry(ChiCTR2000038686).

scholarly journals Anterior quadratus lumborum block for postoperative recovery after total hip arthroplasty: a study protocol for a single-center, double-blind, randomized controlled trial

2019 ◽  
Author(s):  
Masaru Kikuchi ◽  
Takahiro Mihara ◽  
Yusuke Mizuno ◽  
Hiroko Fujimoto ◽  
Sachiko Arai ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lower Limb ◽  
Controlled Trial ◽  
Postoperative Recovery ◽  
Double Blind ◽  
Total Hip ◽  
Randomized Controlled ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum

Abstract Background: Appropriate pain management is essential to improve the postoperative recovery after total hip arthroplasty (THA). Various case reports have indicated that anterior quadratus lumborum block (QLB) provides effective postoperative analgesia in lower limb surgeries. However, there are few randomized controlled trials that have confirmed the efficacy of anterior QLB for lower limb surgeries. The aim of this single-center, double-blind, randomized controlled trial is to confirm the efficacy of anterior QLB for postoperative recovery after THA. Methods: The participants will be randomly assigned to either the anterior QLB group or the placebo group. After induction of general anesthesia, anterior QLB will be performed using 0.25% levobupivacaine or normal saline. Fentanyl will be administered according to blood pressure change during the surgery. The primary outcome will be the quality of recovery 40 score (QoR-40). Secondary outcomes will include the visual analog scale (VAS) score of pain intensity at rest and movement, intraoperative and postoperative doses of fentanyl, and incidence of postoperative nausea and vomiting. Statistical analysis will be performed using the Student’s t-test, Mann–Whitney U-test, and Fisher’s exact test as appropriate. A p < 0.05 will be considered statistically significant. Discussion: The results of our study will reveal whether anterior QLB is effective for postoperative recovery after THA. Trial registration: UMIN Clinical Trials Registry, UMIN000032255. Registered on 15 April 2018. Keywords: anterior quadratus lumborum block, hip osteoarthritis, peripheral nerve block, postoperative pain, regional anesthesia, total hip arthroplasty

scholarly journals Postoperative pain treatment with transmuscular quadratus lumborum block and fascia iliaca compartment block in patients undergoing total hip arthroplasty: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qin Xia ◽  
Wenping Ding ◽  
Chao Lin ◽  
Jiayi Xia ◽  
Yahui Xu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Analgesic Requirement ◽  
Total Hip ◽  
Quality Of Recovery ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Intravenous Analgesia ◽  
Joint Range ◽  
Fascia Iliaca Compartment Block

Abstract Background Patients often suffer moderate or even severe pain after total hip arthroplasty; such pain seriously affects early postoperative recovery. This study aimed to investigate the analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block combined with fascia iliaca compartment block for elderly patients undergoing total hip arthroplasty. Methods Fifty-four patients scheduled for total hip arthroplasty were included in this randomized controlled study. The patients were randomly assigned to receive only transmuscular quadratus lumborum block (group Q) or transmuscular quadratus lumborum block combined with fascia iliaca compartment block (group QF) with ultrasound guidance. Postoperatively in both groups, paracetamol 1 g was regularly administered at 6 h intervals and patient-controlled intravenous analgesia was administered. The primary outcome was cumulative sufentanil consumption via patient-controlled intravenous analgesia 24 h postoperatively. The secondary outcomes included pain degree, time to the first analgesic requirement, joint range of motion, quality of recovery, and the incidence of postoperative complications. Results Fifty patients were included, and their data were analyzed. The cumulative sufentanil consumption in group QF was significantly lower during the first 24 h after surgery than that in group Q, and the cumulative sufentanil consumption in group QF was reduced at 6–12 and 12–18 h after surgery. The postoperative pain intensity was lower in group QF than in group Q (linear mixed-effects model, the main effect of treatment: P < 0.001). Compared with group Q, group QF had higher quality of recovery and joint range of movement. The time to the first analgesic requirement was longer in group QF than in group Q (log-rank, P < 0.001). There was no statistically significant difference in complications postoperatively between the two groups. Conclusions Our study provides a multimodal, opioid-sparing analgesic regimen for elderly patients undergoing total hip arthroplasty. The combination of transmuscular quadratus lumborum block and fascia iliaca compartment block provides a significant advantage for early postoperative functional recovery. Further studies are required to confirm the minimum effective dose. Trial registration The study was registered on the 21st December 2020 (retrospectively registered) on the Chinese Clinical Trial Registry: ChiCTR2000038686.

scholarly journals Anterior quadratus lumborum block for postoperative recovery after total hip arthroplasty: a study protocol for a single-center, double-blind, randomized controlled trial

2020 ◽  
Author(s):  
Masaru Kikuchi ◽  
Takahiro Mihara ◽  
Yusuke Mizuno ◽  
Hiroko Fujimoto ◽  
Sachiko Arai ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lower Limb ◽  
Controlled Trial ◽  
Postoperative Recovery ◽  
Double Blind ◽  
Total Hip ◽  
Randomized Controlled ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum

Abstract Background: Appropriate pain management is essential to improve the postoperative recovery after total hip arthroplasty (THA). Various case reports have indicated that anterior quadratus lumborum block (QLB) provides effective postoperative analgesia in lower limb surgeries. However, there are few randomized controlled trials that have confirmed the efficacy of anterior QLB for lower limb surgeries. The aim of this single-center, double-blind, randomized controlled trial is to confirm the efficacy of anterior QLB for postoperative recovery after THA. Methods: The participants will be randomized to either the anterior QLB or placebo groups, using a set of random numbers for the allocation sequence. Only pharmacists will be aware of the allocations; other investigators will be blinded until study completion. After induction of general anesthesia, anterior QLB will be performed using 0.25% levobupivacaine or normal saline. Fentanyl will be administered according to blood pressure change during the surgery. The primary outcome will be the quality of recovery 40 score (QoR-40). Secondary outcomes will include the visual analog scale (VAS) score of pain intensity at rest and movement, intraoperative and postoperative doses of fentanyl, and incidence of postoperative nausea and vomiting. Statistical analysis will be performed using the Student’s t-test, Mann–Whitney U-test, and Fisher’s exact test as appropriate. A p < 0.05 will be considered statistically significant. Discussion: The results of our study will reveal whether anterior QLB is effective for postoperative recovery after THA. Trial registration: UMIN Clinical Trials Registry, UMIN000032255. Registered on 15 April 2018. Keywords: anterior quadratus lumborum block, hip osteoarthritis, peripheral nerve block, postoperative pain, regional anesthesia, total hip arthroplasty

Quadratus lumborum block for total hip arthroplasty: anatomical knowledge is always key for choice of blocks and execution

2020 ◽  
Vol 46 (1) ◽  
pp. 92-93
Author(s):  
Gudny Steingrimsdottir ◽  
Christian K Hansen ◽  
Mette Dam ◽  
Katrine B Tanggaard ◽  
Martin Vedel Nielsen ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Anatomical Knowledge

Early Wear Performance of Highly Cross-Linked Polyethylene in Total Hip Arthroplasty: A Prospective Randomized Controlled Study

2006 ◽  
Vol 21 (2) ◽  
pp. 303
Author(s):  
Richard W. McCalden ◽  
Steven J. MacDonald ◽  
Cecil H. Rorabeck ◽  
Robert B. Bourne ◽  
David G. Chess
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Wear Performance ◽  
Total Hip ◽  
Randomized Controlled
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