Comparison between ultrasound-guided suprainguinal fascia iliaca block and anterior quadratus lumborum block for total hip arthroplasty: a prospective, double-blind, randomized controlled trial

  • Qiuru Wang
    Affiliations
    Department of Orthopaedics surgery, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People’s Republic of China
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  • Jian Hu
    Affiliations
    Department of Anesthesiology, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People’s Republic of China
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  • Wanli Zhang
    Affiliations
    Public Laboratory Technology Center, West China Hospital, Sichuan University, Xinchuan Road, Chengdu 637000, People’s Republic of China
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  • Yan Zeng
    Affiliations
    Department of Anesthesiology, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People’s Republic of China
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  • Jing Yang
    Correspondence
    Corresponding author: Jing Yang, MD, Professor, Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China, Phone: +862885422426; Fax: +86 28 85423438 ; .
    Affiliations
    Department of Anesthesiology, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People’s Republic of China
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  • Pengde Kang
    Correspondence
    Corresponding author: Pengde Kang, PhD, MD, Professor, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China, Phone: +862885422426; Fax: +86 28 85423438 ;
    Affiliations
    Department of Orthopaedics surgery, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People’s Republic of China
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Published:January 10, 2022DOI:https://doi.org/10.1016/j.arth.2022.01.011

      Abstract

      Background

      Nerve block is a key technique in postoperative analgesia for total hip arthroplasty (THA). This study aimed to compare ultrasound-guided suprainguinal fascia iliaca block (SFIB) and anterior quadratus lumborum block (AQLB) in patients undergoing primary THA.

      Methods

      In this prospective, double-blind, randomized controlled trial, 100 patients undergoing primary THA under general anesthesia were randomly allocated to receive an ultrasound-guided SFIB + sham AQLB (SFIB group), or an ultrasound-guided AQLB + sham SFIB (AQLB group). Before wound suture, all patients received periarticular infiltration analgesia which the local anesthetic was injected into joint capsule, exposed gluteal and abductor muscles, peri-trochanteric zone, and subcutaneous tissue under the incision as multiple sites. The primary outcome was postoperative morphine consumption within 24 hours after surgery. Secondary outcomes were the time to first rescue analgesia, postoperative pain assessed on the visual analogue scale (VAS), postoperative quadriceps strength, the time to hospital discharge, and the incidence of postoperative complications.

      Results

      There were no significant differences between the two groups concerning morphine consumption within 24 hours after surgery (p = 0.774), the time to first rescue analgesia (p = 0.890), the time to hospital discharge (p = 0.532), and the incidence of postoperative complications (p > 0.05). The VAS pain scores at rest and during motion also were similar at all time points (p > 0.05). Significantly more patients in the SFIB group experienced quadriceps muscle weakness at 2 hours (p = 0.008) and 6 hours (p = 0.009) after surgery.

      Conclusion

      Under the circumstances of this study, when combined with periarticular infiltration analgesia, the SFIB provided similar pain relief compared with AQLB in patients undergoing THA, but was associated with muscle weakness within 6 hours after surgery.

      Keywords

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