Key result
Quadratus lumborum block significantly reduced 24-hour opioid consumption (p=0.010) and improved pain control at 6, 12, and 24 hours postoperatively in patients undergoing total hip arthroplasty.
Why the study?
Studies evaluating the role of the relatively new quadratus lumborum block in total hip arthroplasty have reported variable effects.
Does quadratus lumborum block reduce postoperative pain scores and opioid consumption in patients undergoing total hip arthroplasty?
Meta-Analysis (n=394)
Does quadratus lumborum block reduce postoperative pain scores and opioid consumption in patients undergoing total hip arthroplasty?
p-value: p=0.010
Quadratus lumborum block significantly improves postoperative pain control, reduces opioid consumption, and decreases postoperative nausea and vomiting in patients undergoing total hip arthroplasty.
Supports QLB incorporation into THA multimodal analgesia; strengthens pooled RCT evidence for opioid sparing.
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.
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Huda et al. (2022) conducted a meta-analysis in Total hip arthroplasty (n=394). Quadratus lumborum block vs. No block or placebo block was evaluated on 24-hour opioid consumption (p=0.010). Quadratus lumborum block significantly reduced 24-hour opioid consumption (p=0.010) and improved pain control at 6, 12, and 24 hours postoperatively in patients undergoing total hip arthroplasty.
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