Quadratus Lumborum Block Provides Similar or Reduced Postoperative Pain and Opioid Consumption Compared to Control Following Hip Arthroscopy: A Systematic Review

Abstract

Purpose

To investigate whether the quadratus lumborum (QL) block is associated with reduced postoperative pain and opioid consumption in patients undergoing hip arthroscopy.

Methods

A search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed in PubMed, Embase, Scopus, and Cochrane Library databases to identify comparative studies of patients undergoing the QL block before hip arthroscopy. The primary outcomes of interest included postoperative pain and opioid consumption.

Results

Eight studies (5 randomized, 3 nonrandomized) with 274 patients receiving the QL block were included. Control groups included no block (3 studies), sham block (2 studies), pericapsular injection of anesthetic (1 study), lumbar plexus block (1 study), and femoral nerve/fascia iliaca block (1 study). In 1 randomized and 2 nonrandomized studies, the pain scores were significantly lower, at all postoperative time points, in the QL block versus sham, no block, and femoral nerve/fascia iliaca control groups. The same 3 studies reported significantly less opioid consumption in the QL group at all measured postoperative time points. The remaining 5 studies reported mostly no significant differences in pain scores and opioid consumption at multiple postoperative time points. In no study did the QL block group have significantly more pain or opioid consumption relative to the control groups.

Conclusions

Compared to a variety of control groups, the QL block provides similar or reduced postoperative pain and opioid consumption in patients undergoing hip arthroscopy.

Level of Evidence

Level III, systematic review of Level I and III studies.