Continuous Lumbar Plexus Block versus Continuous Quadratus Lumborum Block Type 3 as Post-operative Analgesia in Total Hip Arthroplasty: A Randomized Controlled Trial.

Background: Adequate pain control after total hip arthroplasty (THA) is crucial for promoting early mobilization and minimizing postoperative complications. Regional anesthesia techniques, including lumbar plexus block (LPB) and quadratus lumborum block type 3 (QLB3), can reduce reliance on systemic opioids while providing effective analgesia. The present study aimed to compare these two approaches in terms of postoperative pain relief and opioid consumption. Methods: A total of 48 patients scheduled for total hip arthroplasty under spinal anesthesia were randomized to receive either continuous lumbar plexus block (Group A) or continuous quadratus lumborum block type 3 (Group B). The primary endpoint was postoperative pain intensity measured with the Visual Analogue Scale (VAS). Secondary endpoints included time to first analgesic request, cumulative opioid consumption, block performance time, and length of hospital stay. Results: No significant differences were observed in postoperative pain scores at rest or during movement, nor in the length of hospital stay. The time required to perform the block was significantly shorter for QLB3 compared with LPB. In contrast, opioid consumption during the first six postoperative hours was lower in the LPB group than in the QLB3. Conclusion: Continuous lumbar plexus block and quadratus lumborum block type 3 both offer reliable postoperative pain relief following total hip arthroplasty. LPB appears to provide an advantage in reducing opioid requirements during the early postoperative period, whereas QLB3 offers a quicker and technically simpler block placement. Selection of technique can be tailored within a multimodal analgesic regimen according to clinical circumstances and practitioner experience.