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. 2022 Feb 3:8:771859.
doi: 10.3389/fmed.2021.771859. eCollection 2021.

Efficacy of Quadratus Lumborum Block for Pain Control in Patients Undergoing Hip Surgeries: A Systematic Review and Meta-Analysis

Jinfeng Li  1   2 , Chenpu Wei  1 , Jiangfa Huang  1   2 , Yuguo Li  1 , Hongliang Liu  1   2 , Jun Liu  3   4   5 , Chunhua Jin  6
Affiliations

Efficacy of Quadratus Lumborum Block for Pain Control in Patients Undergoing Hip Surgeries: A Systematic Review and Meta-Analysis

Jinfeng Li et al. Front Med (Lausanne). .

Abstract

Background: Several studies have reported the use of anterior, posterior and lateral quadratus lumborum block (QLB) for pain control in hip surgeries. However, high-quality evidence is lacking. The current review aimed to summarize data on the efficacy of QLB for pain control in patients undergoing hip surgeries.

Methods: PubMed, Embase, and Google Scholar databases were searched up to August 5, 2021 for randomized controlled trials (RCTs) or non-RCTs assessing the efficacy of QLB for any type of hip surgery.

Results: Thirteen studies were included (nine RCTs and four non-RCTs). On pooled analysis, there was a statistically significant reduction of 24-h total opioid consumption in patients receiving QLB as compared to the control group (MD: -9.92, 95% CI: -16.35, -3.48 I 2 = 99% p = 0.003). We noted a statistically significant reduction of pain scores in the QLB group as compared to control group at 2-4 h (MD: -0.57, 95% CI: -0.98, -0.17 I 2 = 61% p = 0.005), 6-8 h (MD: -1.45, 95% CI: -2.09, -0.81 I 2 = 86% p < 0.00001), 12 h (MD: -1.12, 95% CI: -1.89, -0.34 I 2 = 93% p = 0.005), 24 h (MD: -0.71, 95% CI: -1.27, -0.15 I 2 = 89% p = 0.01) and 48 h (MD: -0.76, 95% CI: -1.37, -0.16 I 2 = 85% p = 0.01) after the procedure. There was a statistically significant reduction in the risk of nausea/vomiting (RR: 0.40, 95% CI: 0.18, 0.88 I 2 = 62% p = 0.02) in patients receiving QLB but no difference in the risk of pruritis (RR: 0.46, 95% CI: 0.17, 1.24 I 2 = 16% p = 0.13) and urinary retention (RR: 0.44, 95% CI: 0.19, 1.02 I 2 = 0% p = 0.06).

Conclusion: QLB as a part of a multimodal analgesic regimen reduces opioid consumption and pain scores in patients undergoing hip surgeries. The certainty of evidence based on GRADE was moderate. Despite the statistically significant results, the clinical relevance of the analgesic efficacy of QLB is debatable due to the small effect size.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021267861.

Keywords: arthroplasty; arthroscopy; hip surgery; nerve block; pain.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Risk of bias plot for RCTs.
Figure 3
Figure 3
Risk of bias plot for non-RCTs.
Figure 4
Figure 4
Meta-analysis of 24-h total analgesic consumption between QLB and control groups with sub-group analysis based on study type.
Figure 5
Figure 5
Meta-analysis of pain scores between QLB and control groups with sub-group at different time points.
Figure 6
Figure 6
Meta-analysis of adverse events between QLB and control groups.
See this image and copyright information in PMC

References

    1. Hasan K, Shankar S, Sharma A, Carter A, Zaidi R, Cro S, et al. Hip surgery and its evidence base: progress over a decade? J Orthop Traumatol. (2016) 17:291–5. 10.1007/s10195-016-0421-z - DOI - PMC - PubMed
    1. Min K, Beom J, Kim BR, Lee SY, Lee GJ, Lee JH, et al. Clinical practice guideline for postoperative rehabilitation in older patients with hip fractures. Ann Rehabil Med. (2021) 45:225–59. 10.5535/arm.21110 - DOI - PMC - PubMed
    1. Okamoto T, Ridley RJ, Edmondston SJ, Visser M, Headford J, Yates PJ. Day-of-surgery mobilization reduces the length of stay after elective hip arthroplasty. J Arthroplasty. (2016) 31:2227–30. 10.1016/j.arth.2016.03.066 - DOI - PubMed
    1. Bugada D, Bellini V, Lorini LF, Mariano ER. Update on selective regional analgesia for hip surgery patients. Anesthesiol Clin. (2018) 36:403–15. 10.1016/j.anclin.2018.04.001 - DOI - PubMed
    1. Indelli PF, Grant SA, Nielsen K, Vail TP. Regional anesthesia in hip surgery. Clin Orthop Relat Res. (2005) 441:250–5. 10.1097/01.blo.0000192355.71966.8e - DOI - PubMed

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