Key result
Ultrasound-guided quadratus lumborum block lowers movement-related pain at 4 hours vs parecoxib in hip surgery.
Why the study?
Given the growing importance of preventive analgesia for patient comfort, the study explored the efficacy and safety of ultrasound-guided quadratus lumborum block in elderly patients undergoing hip surgery.
Does ultrasound-guided quadratus lumborum block reduce perioperative pain in elderly patients undergoing hip surgery?
RCT (n=83)
Double-blind
Computer-generated random assignment sequence
No
Does ultrasound-guided quadratus lumborum block reduce perioperative pain in elderly patients undergoing hip surgery?
Absolute Event Rate: 2% vs 3%
p-value: p=<0.001
Ultrasound-guided quadratus lumborum block provides effective preventive analgesia, reducing acute pain and pain during positioning for spinal anesthesia in elderly patients undergoing hip surgery.
Favors quadratus lumborum block over parecoxib for acute pain management in elderly hip surgery; extends RCT evidence for regional anesthesia in preventive analgesia.
Objective As patient comfort is important, the importance of preventive analgesia is increasing. This trial was conducted to explore the efficacy and safety of ultrasound-guided quadratus lumborum block for elderly patients in the perioperative period of hip surgery. Methods Patients who planned to undergo hip surgery were randomly assigned to the intervention group or the control group. The intervention group received an ultrasound-guided quadratus lumborum block one day before surgery. The pain score, sleep quality, inflammatory indexes and incidence of adverse reactions were compared between the two groups. Results We conducted a randomized, controlled, double-blind trial. Patients who planned to undergo hip surgery were recruited and randomly assigned to either the intervention group or the control group. A total of 83 patients were included in the trial. The NRS score of the intervention group was significantly lower than that of the control group at 4 h after nerve block and in the knee-thoracic position under anaesthesia ( P < 0.05). The sleep quality of the two groups was significantly better on the day of surgery and postoperative day 1 and 2 days than that before surgery ( P < 0.05). Conclusions Ultrasound-guided quadratus lumborum block for preventive analgesia in elderly patients undergoing hip surgery can effectively relieve acute pain, reduce pain associated with position change under anaesthesia, improve sleep quality during the perioperative period, and avoid increasing inflammatory stress or the incidence of adverse reactions. Trial registration: Clinical trial registration number: ChiCTR2100050537. Full date of the first registration: 28/08/2021.
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Yu et al. (2023) conducted an RCT in Hip fracture (n=83). Ultrasound-guided quadratus lumborum block vs. 40 mg parecoxib sodium was evaluated on NRS score during movement at 4 hours after nerve block (p=<0.001). Ultrasound-guided quadratus lumborum block significantly reduced movement-related pain scores at 4 hours post-block (median NRS 2 vs 3, P<0.001) compared to parecoxib sodium in elderly patients undergoing hip surgery.
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