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Review
. 2024 May 29;13(11):3194.
doi: 10.3390/jcm13113194.

Efficacy of Continuous Lumbar Plexus Blockade in Managing Post-Operative Pain after Hip or Femur Orthopedic Surgeries: A Systematic Review and Meta-Analysis

Wijdan A AlMutiri  1 , Ebtesam AlMajed  1 , Muath M Alneghaimshi  2 , Afnan AlAwadh  1 , Reem AlSarhan  1 , Malak N AlShebel  3 , Rayan Abdullah M AlMatrody  4 , Rafa Hadaddi  5 , Reem AlTamimi  1 , Rawan Bin Salamah  1 , Lama A AlZelfawi  1 , Saud K AlBatati  2 , Alanood AlHarthi  1 , Ghayda AlMazroa  6 , Abdullah M AlHossan  2
Affiliations
Review

Efficacy of Continuous Lumbar Plexus Blockade in Managing Post-Operative Pain after Hip or Femur Orthopedic Surgeries: A Systematic Review and Meta-Analysis

Wijdan A AlMutiri et al. J Clin Med. .

Abstract

Background: Post-operative pain management is essential for optimizing recovery, patient comfort, and satisfaction. Peripheral nerve blockade, or lumbar plexus block (LPB), has been widely used for analgesia and regional anesthesia. This study explored the existing literature to determine the efficacy of continuous lumbar plexus blockade in managing post-operative pain following hip or femur surgery. Methods: Reviewers comprehensively searched electronic databases to identify peer-reviewed scholarly articles reporting the efficacy of lumbar plexus block in managing post-operative pain after orthopedic surgery. The potential articles were carefully selected and assessed for the risk of bias using the Cochrane Collaboration Risk of Bias assessment tool. Data were systematically extracted and analyzed. Results: The literature search yielded 206 articles, 20 of which were randomized controlled trials. Lumbar plexus block demonstrated superior pain relief compared to conventional pain management approaches like general anesthetics. In addition, LPB reduced patients' overall opioid consumption compared to controls, reduced adverse effects, and enhanced functional recovery, which underlines the broader positive impact of meticulous pain management. More patients could walk more than 40 feet after the second day post-operatively among the lumbar plexus group (14.7%) compared to the continuous femoral group (1.3%). Other parameters, including cortisol levels and hemodynamic stability, were evaluated, showing comparable outcomes. Conclusions: Lumbar plexus block is effective in pain management after orthopedic surgery, as shown by the lower pain scores and less opioid consumption. Additionally, patient satisfaction was relatively higher in LPB-treated patients compared to other approaches like general anesthesia.

Keywords: lumbar plexus block; orthopedic surgery; pain management.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Risk of bias assessment summary.
Figure 3
Figure 3
Risk of bias assessment graph.
Figure 4
Figure 4
Forest plot comparing VAS pain scores between LPB-treated patients and controls without LPB.
Figure 5
Figure 5
Forest plot comparing NRS pain scores between LPB-treated patients and controls without LPB.
Figure 6
Figure 6
Forest plot comparing cortisol levels in LPB-treated patients and control groups without LPB [33,34].
Figure 7
Figure 7
Forest plot showing the incidences of nausea among LPB patients.
Figure 8
Figure 8
Forest plot comparing systolic blood pressure in LPB-treated patients and controls.
Figure 9
Figure 9
Forest plot comparing diastolic blood pressure in LPB-treated patients and controls.
Figure 10
Figure 10
Forest plot comparing heart rate in LPB-treated patients and controls.
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