Quadratus lumborum block provides improved immediate postoperative analgesia and decreased opioid use compared with a multimodal pain regimen following hip arthroscopy

Abstract

The purpose of our study was to evaluate the effect on immediate patient outcomes following hip arthroscopy with use of a preoperative, single shot quadratus lumborum (QL) block. We retrospectively reviewed patients who underwent hip arthroscopy following a preoperative QL block. These patients were matched by age and gender to patients who had not received a block. Visual analogue scale (VAS) pain scores immediately postoperatively and at the time of discharge were recorded. Hourly and overall opioid intake in the postanesthesia care unit (PACU) was also recorded. Continuous data was analysed with paired t-test, with significance being defined as P < 0.05. Complications in the immediate postoperative period were recorded, as was time from admission to PACU to discharge. Fifty-six patients were included. Twenty-eight patients underwent QL block and 28 did not undergo a block. QL block patients required significantly less hydromorphone (P = 0.010) and oxycodone (P = 0.001) during their time in the PACU, and significantly fewer morphine equivalents overall and per hour in the PACU (P < 0.001). Despite receiving less opioid analgesia, QL block patients had significantly less pain immediately postoperatively (P = 0.026) and at the time of discharge (P = 0.015). The mean time to PACU discharge was 155 ± 49 min, and there was no difference in time to discharge between groups (P = 0.295). One patient in the QL block group experienced persistent flank numbness. Hip arthroscopy patients who received a preoperative QL block had less pain and a lower opioid requirement in PACU than those who did not receive a block. Level of Evidence: Level III (Retrospective matched cohort study).

Ultrasound Guided Continuous Quadratus Lumborum Block Hastened Recovery in Patients Undergoing Open Liver Resection: A Randomized Controlled, Open-label Trial

“…Quadratus lumborum block is an emerging technique for peripheral nerve blockade, which generates an analgesic effect by unilaterally blocking spinal nerves from T6-T9 to L1-L3 [9] Considering its wide block range, It has been increasingly used for postoperative analgesia in patients undergoing middle and lower abdominal and hip surgery [10][11][12], and showed satisfactory results no matter in single injection mode or continuous infusion mode. However, application of continuous QL block for upper abdominal pain is less well characterized.…”

Ultrasound-guided Quadratus Lumborum Block for Perioperative Analgesia in Robot-assisted Partial Nephrectomy: A Randomized Controlled Trial

“…Ultrasound-guided QLB technique was first described by Blanco [11,12], and the benefits of QLB for postoperative pain relief and opioids-sparing effect have been reported by several randomized controlled trials and case reports [2,5,6,[8][9][10][19][20][21][22][23][24][25][26][27][28][29][30]. All approaches have been proved the synergistic efficacy for multimode analgesia, especially for QLB2 or QLB3 after laparoscopic surgery, cesarean section and total hip arthroplasty.…”

Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeriesA systematic review and meta-analysis of randomized controlled trials

“…Therefore, it has an effect on visceral pain and abdominal incision pain. Additional studies [7,12,31] have shown that two different trunk blocks have adequate analgesic effects for the management of pain after abdominal surgery.…”