Postoperativepainisan important problem after total hiparthroplasty.Several modalities are
usually usedforpostoperative analgesia in these patients including neuraxial analgesia,
intravenous analgesia, andperipheralnerveblocks.Peripheral
nerveblockshavetheadvantageofpotentanalgesia, lower motor impairment, and minimal systemic
complications.The commonlyperformed peripheral nerveblocks for hip surgeriesinclude
suprainguinalfasciailiacablock(FIB)and lumbar plexusblock.Quadratus lumborum (QL) block is
a newlydeveloped blockwithgoodperformancein lower abdominal and hip surgery.Seventy
patients aged from 8-70 years old, with ASA physical status I-III and scheduled for dynamic hip
screw surgery under subarachnoid block (SAB) hip had been included in the study. Patients were
randomly allocated using concealed closed envelope method into one of two groups:FICB Group
(n=35): this group received suprainguinal fascia iliaca block, the end point of the injection is
deep to the fascia iliaca and above the iliacus muscle inthe lateral part of the iliacus muscle.
After negative aspiration, 30 mL of 0.25 % of bupivacaine will be injected under the fascial
plane incrementally, aspirating every 5 ml.QLB Group (n=35): this group received ultrasoundguided transmuscular quadratus lumborum block; (Anterior QLB or QLB III), the needle tip will
be placed between the psoas major muscle and the quadratus lumborum
muscle.Afternegativeaspiration,30 mL of0.25% ofbupivacaine will be injected into the fascial
plane incrementally, aspirating every 5 ml.Both FIB and transmuscular QLB were effective at
providing early postoperative analgesia after hip arthroplasty surgeries with comparable static
and dynamic VAS in the first 24 hours postoperative and comparable duration of analgesia.Both
singleshot blocks,namelysuprainguinalFIB andtransmuscularQLB,provided effective
postoperative analgesia afterTHA.FIBshowedslightlylower24-hour morphine consumption. |
