Nassar Heba, Hasanin Ahmed, Sewilam Mahmoud, Ahmed Heba, Abo-Elsoud Mohamed, Taalab Omar, Rady Ashraf, Zoheir Heba Allah
Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Orthopedic Surgery, Cairo University, Cairo, Egypt.
Local Reg Anesth. 2021 Apr 20;14:67-74. doi: 10.2147/LRA.S308964. eCollection 2021.
This study aimed to investigate the analgesic efficacy and motor block profile of single-shot transmuscular quadratus lumborum block (QLB) in comparison with those of suprainguinal fascia iliaca block (FIB) in patients undergoing hip arthroplasty.
This randomized, double-blinded, controlled trial included adult patients undergoing hip arthroplasty under spinal anesthesia. Patients were allocated to one of two groups according to the regional block received: FIB group (n=19) or QLB group (n=17). Both study groups were compared with regard to the duration of analgesia (primary outcome), block performance time, pain during positioning for spinal anesthesia, total morphine consumption in the first postoperative 24-h period, quadriceps muscle power, and static and dynamic visual analog scale.
Thirty-six patients were included in the final analysis. Both study groups had comparable durations of analgesia. Postoperative visual analog scale (static and dynamic) values were comparable between the two groups in most readings. The block performance time was shorter in the FIB group. The number of patients with pain during positioning for the subarachnoid block was lower in the QLB group. The total morphine requirement during the first 24 h was marginally lower in the FIB group, whereas the quadriceps motor grade was higher in the FIB group than in the QLB group at 4 h and 6 h after surgery.
Both single-shot blocks, namely the suprainguinal FIB and transmuscular QLB, provide effective postoperative analgesia after hip arthroplasty. FIB showed slightly lower 24-h morphine consumption, while QLB showed better quadriceps motor power.
The study was registered at clinical trials registry system before enrollment of the first participant (NCT04005326; initial release date, 2 July 2019; https://clinicaltrials.gov/ct2/show/NCT04005326).
本研究旨在比较单次经肌肉腰方肌阻滞（QLB）与腹股沟上髂筋膜阻滞（FIB）在髋关节置换术患者中的镇痛效果和运动阻滞情况。
本随机、双盲、对照试验纳入了在脊髓麻醉下接受髋关节置换术的成年患者。根据接受的区域阻滞将患者分为两组之一：FIB组（n = 19）或QLB组（n = 17）。比较两个研究组的镇痛持续时间（主要结局）、阻滞操作时间、脊髓麻醉定位时的疼痛、术后24小时内的吗啡总消耗量、股四头肌力量以及静态和动态视觉模拟评分。
36例患者纳入最终分析。两个研究组的镇痛持续时间相当。在大多数读数中，两组术后视觉模拟评分（静态和动态）值相当。FIB组的阻滞操作时间较短。蛛网膜下腔阻滞定位时疼痛的患者数量在QLB组中较低。FIB组术后24小时内的吗啡总需求量略低，而术后4小时和6小时FIB组的股四头肌运动分级高于QLB组。
单次阻滞，即腹股沟上FIB和经肌肉QLB，在髋关节置换术后均提供有效的术后镇痛。FIB显示24小时吗啡消耗量略低，而QLB显示股四头肌运动能力更好。
该研究在第一名参与者入组前在临床试验注册系统中注册（NCT04005326；初始发布日期，2019年7月2日；https://clinicaltrials.gov/ct2/show/NCT04005326）。
