Transmuscular Quadratus Lumborum Block versus Suprainguinal Fascia Iliaca Block for Hip Arthroplasty: A Randomized, Controlled Pilot Study.

IF 1.5 Q3 ANESTHESIOLOGY Local and Regional Anesthesia Pub Date : 2021-04-20 eCollection Date: 2021-01-01 DOI:10.2147/LRA.S308964
Heba Nassar, Ahmed Hasanin, Mahmoud Sewilam, Heba Ahmed, Mohamed Abo-Elsoud, Omar Taalab, Ashraf Rady, Heba Allah Zoheir
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引用次数: 13

Abstract

Background: This study aimed to investigate the analgesic efficacy and motor block profile of single-shot transmuscular quadratus lumborum block (QLB) in comparison with those of suprainguinal fascia iliaca block (FIB) in patients undergoing hip arthroplasty.

Methods: This randomized, double-blinded, controlled trial included adult patients undergoing hip arthroplasty under spinal anesthesia. Patients were allocated to one of two groups according to the regional block received: FIB group (n=19) or QLB group (n=17). Both study groups were compared with regard to the duration of analgesia (primary outcome), block performance time, pain during positioning for spinal anesthesia, total morphine consumption in the first postoperative 24-h period, quadriceps muscle power, and static and dynamic visual analog scale.

Results: Thirty-six patients were included in the final analysis. Both study groups had comparable durations of analgesia. Postoperative visual analog scale (static and dynamic) values were comparable between the two groups in most readings. The block performance time was shorter in the FIB group. The number of patients with pain during positioning for the subarachnoid block was lower in the QLB group. The total morphine requirement during the first 24 h was marginally lower in the FIB group, whereas the quadriceps motor grade was higher in the FIB group than in the QLB group at 4 h and 6 h after surgery.

Conclusion: Both single-shot blocks, namely the suprainguinal FIB and transmuscular QLB, provide effective postoperative analgesia after hip arthroplasty. FIB showed slightly lower 24-h morphine consumption, while QLB showed better quadriceps motor power.

Clinical trial registration: The study was registered at clinical trials registry system before enrollment of the first participant (NCT04005326; initial release date, 2 July 2019; https://clinicaltrials.gov/ct2/show/NCT04005326).

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经肌腰方肌阻滞与腹股沟上髂筋膜阻滞用于髋关节置换术:一项随机、对照的先导研究。
背景:本研究旨在探讨单次经肌腰方肌阻滞(QLB)与腹股沟上髂筋膜阻滞(FIB)在髋关节置换术患者中的镇痛效果和运动阻滞特征。方法:这项随机、双盲、对照试验包括在脊髓麻醉下接受髋关节置换术的成年患者。根据所接受的区域阻滞将患者分为两组:FIB组(n=19)或QLB组(n=17)。比较两组患者镇痛时间(主要结局)、阻滞时间、脊柱麻醉定位疼痛、术后24小时吗啡总消耗量、股四头肌力量、静态和动态视觉模拟量表。结果:36例患者纳入最终分析。两个研究组的镇痛持续时间相当。两组术后视觉模拟量表(静态和动态)在大多数读数上具有可比性。FIB组阻滞时间短。QLB组在放置蛛网膜下腔阻滞时出现疼痛的患者数量较低。FIB组术后24小时吗啡总需要量略低于QLB组,但术后4小时和6小时FIB组股四头肌运动等级高于QLB组。结论:腹股沟上FIB和经肌QLB两种单次阻滞均可有效缓解髋关节置换术后的疼痛。FIB显示24小时吗啡消耗稍低,而QLB显示股四头肌运动功率较好。临床试验注册:本研究在第一名受试者入组前在临床试验注册系统注册(NCT04005326;首发日期:2019年7月2日;https://clinicaltrials.gov/ct2/show/NCT04005326)。
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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
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