Efficacy of Ultrasound-Guided Quadratus Lumborum Block in Postoperative Analgesia of Total Hip Replacement

Moderate or even severe pain is frequently reported in patients after total hip arthroplasty, severely compromising early postoperative recovery. Previous studies have reported favorable results using anterior, posterior and lateral quadratus lumborum block for pain control during hip surgery. In this study, we evaluate the effectiveness of ultrasound-guided quadratus lumborum block in postoperative analgesia of total hip replacement. 200 patients who underwent total hip arthroplasty in our hospital between January 2020 and January 2021 were recruited and assigned via random number table method to receive either ultrasound-guided quadratus lumborum block (study group) or fascia iliaca block (observation group) for anesthesia. All patients were given self-administered intravenous analgesia postoperatively. Outcome measures included cumulative postoperative sufentanil use, resting pain, motor pain, postoperative hip mobility and incidence of nausea and vomiting. Ultrasound-guided quadratus lumborum block resulted in significantly less sufentanil use in patients at 24 h and 48 h postoperatively (52.14 +/- 5.11, 105.74 +/- 8.14) vs. fascia iliaca block (77.58 +/- 7.93, 150.18 +/- 10.58) (p<0.05). Patients in the study group showed lower visual analogue scale scores both at rest and at exercise than those in the observation group at 12, 24 and 48 h postoperatively (p<0.05). The study group had significantly greater maximum hip flexion and abduction mobility at 24 h and 48 h postoperatively than the observation group (p<0.05). Ultrasound-guided quadratus lumborum block was associated with a lower incidence of nausea and vomiting (7.00 %) vs. fascia iliaca block (39.00 %) (p<0.05). Ultrasound-guided quadratus lumborum block reduces the use of opioids in total hip replacement patients, significantly alleviates surgical pain, promotes early functional recovery and lowers the incidence of adverse effects.