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 prior to 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 (LP) block (1 study), and femoral nerve/fascia iliaca (FN/FI) block (1 study). In one randomized and two nonrandomized studies, the pain scores were significantly lower, at all postoperative time points, in the QL block versus sham, no block, and FN/FI control groups. The same three studies reported significantly less opioid consumption in the QL group at all measured postoperative time points. The remaining five 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 to reduced postoperative pain and opioid consumption in patients undergoing hip arthroscopy.

Level of evidence: III, systematic review of level I and III studies.