COMPARISON OF ULTRASOUND-GUIDED LUMBAR ERECTOR SPINAE PLANE BLOCK AND TRANSMUSCULAR QUADRATUS LUMBORUM BLOCK FOR POST-OPERATIVE ANALGESIA IN TOTAL HIP REPLACEMENT SURGERIES: A PROSPECTIVE RANDOMIZED STUDY

SANGEETHA C; MALATHI ANIL KUMAR; VIJAYAKUMAR M HEGGERI; APARNA BATHALPALLI

doi:10.22159/ajpcr.2024v17i11.53040

Authors

SANGEETHA C Department of Anesthesiology, Sanjay Gandhi Institute of Trauma and Orthopaedic, Bengaluru, Karnataka, India
MALATHI ANIL KUMAR Department of Anesthesiology, Sanjay Gandhi Institute of Trauma and Orthopaedic, Bengaluru, Karnataka, India
VIJAYAKUMAR M HEGGERI Department of Cardiac anaesthesia, Sri Jayadeva Institute of Cardiovascular Science and Research, Bengaluru, Karnataka, India.
APARNA BATHALPALLI Department of Cardiac anaesthesia, Sri Jayadeva Institute of Cardiovascular Science and Research, Bengaluru, Karnataka, India.

DOI:

https://doi.org/10.22159/ajpcr.2024v17i11.53040

Keywords:

Multimodal analgesia, Total hip replacement, Erector spinae plane block, Quadratus lumborum block

Abstract

Objectives: The objective of the study is to compare the efficacy of ultrasound-guided lumbar erector spinae plane block (ESPB) and transmuscular quadratus lumborum block (QLB) in providing post-operative analgesia for patients undergoing total hip replacement (THR) surgeries.

Methods: This prospective, randomized, double-blind study compared the efficacy of ultrasound-guided lumbar ESPB and transmuscular QLB (QLB-t) for post-operative analgesia in THR surgeries. Ninety patients were randomized into three groups: ESPB, QLB, and a control group. Primary outcomes included the duration of analgesia, measured by numeric rating scale scores, and secondary outcomes assessed total analgesic consumption and the incidence of post-operative nausea and vomiting (PONV) within 24 h. For statistical purposes, p<0.05 was taken as statistically significant.

Results: This study compared lumbar ESPB and QLB for post-operative analgesia in THR surgeries. At the 1st h, pain scores were significantly lower in the ESPB (1.30) and QLB (1.05) groups compared to the control group (2.15) (p<0.001). Tramadol consumption in the first 12 h was significantly lower in the ESPB (52.3 mg) and QLB (50.1 mg) groups compared to the control group (135.20 mg) (p<0.001). PONV was absent in 60% of ESPB and 63% of QLB patients, compared to only 33% in the control group (p=0.038).

Conclusion: Lumbar-ESPB and QLB-t blocks effectively reduce post-operative pain and analgesic requirements in THR surgeries, showing comparable benefits. Both techniques also lower the incidence of PONV.

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