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. 2018 Oct-Dec;12(4):825-831.
doi: 10.4103/aer.AER_142_18.

Comparison of Ultrasound-Guided Lumbar Erector Spinae Plane Block and Transmuscular Quadratus Lumborum Block for Postoperative Analgesia in Hip and Proximal Femur Surgery: A Prospective Randomized Feasibility Study

Serkan Tulgar  1 , Halil Cihan Kose  2 , Onur Selvi  1 , Ozgur Senturk  1 , David Terence Thomas  3 , Mehmet Nurullah Ermis  4 , Zeliha Ozer  1
Affiliations

Comparison of Ultrasound-Guided Lumbar Erector Spinae Plane Block and Transmuscular Quadratus Lumborum Block for Postoperative Analgesia in Hip and Proximal Femur Surgery: A Prospective Randomized Feasibility Study

Serkan Tulgar et al. Anesth Essays Res. 2018 Oct-Dec.

Abstract

Study objective: Lumbar Erector spinae Plane block (L-ESPB) is a modification of a recently described block. Both L-ESPB and Transmuscular Quadratus Lumborum block (QLB-T) have been reported to provide effective postoperative analgesia in hip and proximal femur surgery. Herein, we compare the effectiveness of L-ESPB and QLB-T in providing postoperative analgesia in patients undergoing hip and femur operations.

Design: Double-blinded, prospective, randomized, feasibility study.

Setting: Tertiary university hospital, postoperative recovery room and ward.

Methodology: A total of 72 patients (American Society of Anesthesiology physical status classification II-III) were recruited. After exclusion, 60 patients were allocated to three equal groups (control, L-ESB and QLB-t).

Interventions: Standard multimodal analgesia was performed in the control group while L-ESPB or QLB-T was performed in the block groups.

Measurements: Pain intensity between groups was compared using Numeric Rating Scores. Furthermore, tramadol consumption and additional rescue analgesic requirement was measured.

Results: There was no difference between demographic data or type of surgery. While there was no difference in Numeric Rating Scale (NRS) score at any hour between the block groups; NRS scores at the 1st, 3rd and 6th h, tramadol consumption during the first 12 h and total tramadol consumption, the number of patient required rescue analgesic in 24 h were significantly higher in the control group compared to both block groups.

Conclusion: While L-ESPB and QLB-T have similar effect, they improve analgesia quality in patients undergoing hip and proximal femoral surgery when compared to standard intravenous analgesia regimen.

Keywords: Erector spinae plane block; hip surgery; quadratus lumborum block.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
CONSORT diagram of study
Figure 2
Figure 2
(a-c) Performing of QLB-t, (d-f) Performing of L-ESPB, QLM: Quadratus Lumborum muscle, PM: Psoas muscle, ESM: Erector spinae muscles, L4: Transvers process of 4th lumbar vertebra, L5: Transvers process of 5th lumbar vertebra, Sc: Sacrum, Yellow arrow: injection point, Black arrows: Spread are of local anesthetics
See this image and copyright information in PMC

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