The effect of post-operative ultrasound-guided transmuscular quadratus lumborum block on post-operative analgesia after hip arthroplasty in elderly patients: A randomised controlled double-blind study

Abduallah, Mohammad Ali; Ahmed, Sameh Abdelkhalik; Abdelghany, Mohamed

doi:10.4103/ija.ija_275_20

Cited by 20 publications

(29 citation statements)

References 33 publications

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“…The QLB techniques and analgesic regimens used in included studies are presented in Table 1 and online Supporting Information (Appendix S3), respectively. In seven studies, QLB was performed pre‐operatively [5, 6, 8, 28, 39, 40, 44]; in one, intra‐operatively [38]; in nine, postoperatively [27, 29, 30, 32, 33, 41–43, 45]; and one study did not specify the timing of block performance [31]. The majority of studies performed an anterior QLB [6, 8, 27–30, 32, 33, 38, 40–45], whereas two performed a posterior QLB [5, 39].…”

Section: Resultsmentioning

confidence: 99%

“…A subsequent search of the U.S. Clinical Trials Registry identified an additional citation for which the author provided data for inclusion [27]. Search of the WanFang Medical Database identified 14 potentially eligible citations of which 10 were included [28][29][30][31][32][33][34][35][36][37], giving a total of 18 randomised controlled trials included in this review [5,6,8,[27][28][29][30][31][32][33][38][39][40][41][42][43][44][45] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…In seven studies, QLB was performed pre‐operatively [5, 6, 8, 28, 39, 40, 44]; in one, intra‐operatively [38]; in nine, postoperatively [27, 29, 30, 32, 33, 41–43, 45]; and one study did not specify the timing of block performance [31]. The majority of studies performed an anterior QLB [6, 8, 27–30, 32, 33, 38, 40–45], whereas two performed a posterior QLB [5, 39]. One study included any QLB approach (anterior, posterior or lateral) [41] and another did not specify the block approach [31].…”

Section: Resultsmentioning

confidence: 99%

“…With the addition of QLB to spinal anaesthesia, rest pain scores at all pre‐specified time‐points were provided by seven studies inclusive of 513 patients (QLB, 256; control, 257) [6, 27, 29–33]. Across the 24‐h time interval, QLB improved AUC rest pain scores by a weighted mean difference (95%CI) of −4.19 cm.h (−7.20 to −1.18; p = 0.014; I 2 = 98%; Fig.…”

Section: Resultsmentioning

confidence: 99%

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Analgesic benefits of the quadratus lumborum block in total hip arthroplasty: a systematic review and meta‐analysis

et al. 2022

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Summary The quadratus lumborum block (QLB) is reported to reduce pain and improve function following total hip arthroplasty; however, randomised controlled trials evaluating the benefits of adding this block to general or spinal anaesthesia in this population are conflicting. We performed a systematic review seeking randomised controlled trials investigating QLB benefits for total hip arthroplasty, stratifying comparisons regarding the addition of QLB to either general or spinal anaesthesia. The primary outcome was 24‐h area under the curve (AUC) pain score. Pain scores were interpreted in the context of a population‐specific minimal clinically important difference of 1.86 cm on a 10‐cm visual analogue scale, or an AUC pain score of 5.58 cm.h. Secondary outcomes included analgesic consumption, functional recovery and opioid‐related side‐effects. In all, 18 trials (1318 patients) were included. Adding QLB to general or spinal anaesthesia improved 24‐h AUC rest pain scores by a mean difference (95%CI) of −3.56 cm.h (−6.70 to −0.42; p = 0.034) and − 4.19 cm.h (−7.20 to −1.18; p = 0.014), respectively. These improvements failed to reach the pre‐determined minimal clinically important difference, as did the reduction in analgesic consumption. Quadratus lumborum block improved functional recovery for general, but not spinal, anaesthesia. Opioid‐related side‐effects were reduced with QLB regardless of anaesthetic modality. Low‐to‐moderate quality evidence suggests that the extent to which adding QLB to either general or spinal anaesthesia reduces postoperative pain and opioid consumption after total hip arthroplasty is statistically significant but may be clinically unimportant for most patients. However, adding QLB to general anaesthesia might enhance functional recovery. Taken together, our findings do not support the routine use of QLB as part of multimodal analgesic regimens for total hip arthroplasty.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Analgesic benefits of the quadratus lumborum block in total hip arthroplasty: a systematic review and meta‐analysis

et al. 2022

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“…[ 1 ] It is interesting to note that in its early years, the original articles submitted for publication to the Indian Journal of Anaesthesia (IJA) lacked sufficient details of data analysis except for a mention of the “mean” and “ P value <0.05”.However, over the years, there has been a significant improvement in their quality. [ 2 3 4 5 6 7 8 9 10 11 12 ] The research process has undergone continual evolution with the proper application of sound research ethics, study methodology, ways of interpretation of observations and presentation.…”

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confidence: 99%