Transmuscular Quadratus Lumborum Block versus Infrainguinal Fascia Iliaca Nerve Block for Patients Undergoing Elective Hip Replacement: A Double-blinded, Pilot, Randomized Controlled Trial.

IF 1.5 Q3 ANESTHESIOLOGY
Local and Regional Anesthesia Pub Date : 2022-07-06 eCollection Date: 2022-01-01 DOI:10.2147/LRA.S350033
Junaid Hashmi, Barbara Cusack, Lauren Hughes, Vikash Singh, Karthikeyan Srinivasan
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引用次数: 2

Abstract

Purpose: Transmuscular quadratus lumborum (TQL) block has been described as an effective option for postoperative analgesia in patients undergoing hip replacement with single injection described as providing analgesia for up to 24 h. We hypothesize that a TQL block, when compared to fascia iliaca block (FIB), will provide better analgesia and less motor block in the initial 24-h postoperative period.

Patients and methods: Fifty patients undergoing elective hip replacement surgery, ASA I-III, were included in the study. Patients were randomized into two groups. Patients in group A received spinal anesthesia followed by FIB. Patients in group B received spinal anesthesia followed by TQLB. Postoperative pain scores and motor block were assessed at 6 and 24 hours. The primary outcome measure was 24 h total morphine consumption. Secondary outcome measures included pain score (VNS) and motor block (modified Bromage scale) at 6 and 24 h postoperatively.

Results: There was no statistical difference in morphine consumption between the two groups (p-value 0.699). There was no difference in pain scores at 6 h (p-value 0.540) or 24 h (p-value 0.383). There was no difference in motor block at 6 h (p-value 0.497) or at 24 h (p-value 0.773).

Conclusion: Transmuscular quadratus lumborum block along with spinal anesthesia for patients undergoing elective hip replacement surgery does not reduce opioid consumption or motor weakness when compared to fascia iliaca block. The results and conclusion apply to a dose of 20 mL of 0.25% bupivacaine used in each group.

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选择性髋关节置换术患者经腰方肌阻滞与腹股沟下髂筋膜神经阻滞:一项双盲、先导、随机对照试验。
目的:经肌腰方肌阻滞(TQL)已被描述为髋关节置换术患者术后镇痛的有效选择,单次注射可提供长达24小时的镇痛。我们假设与髂筋膜阻滞(FIB)相比,TQL阻滞将在术后最初24小时内提供更好的镇痛和更少的运动阻滞。患者和方法:50例接受择期髋关节置换术的患者被纳入研究,ASA I-III。患者随机分为两组。A组患者行脊髓麻醉后FIB。B组患者先行脊髓麻醉后行TQLB。术后6和24小时分别评估疼痛评分和运动阻滞。主要结局指标为24小时吗啡总消耗量。次要指标包括术后6和24小时的疼痛评分(VNS)和运动阻滞(改良Bromage量表)。结果:两组吗啡用量比较差异无统计学意义(p值为0.699)。6 h (p值0.540)和24 h (p值0.383)疼痛评分无差异。6 h (p值0.497)和24 h (p值0.773)运动阻滞无差异。结论:与髂筋膜阻滞相比,经肌腰方肌阻滞联合脊髓麻醉对择期髋关节置换术患者并不能减少阿片类药物的消耗或运动无力。结果和结论适用于每组使用0.25%布比卡因20 mL。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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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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