Posterior Quadratus Lumborum Block in Total Hip Arthroplasty: A Randomized Controlled Trial
| Autor: | Xavier Capdevila, Sophie Bringuier, Helen Nguyen, Olivier Choquet, Sophia Margareta Brixel, Yassir Aarab, Philippe Biboulet, Fabien Swisser |
|---|---|
| Přispěvatelé: | Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Hôpital Lapeyronie [Montpellier] (CHU), Institut des Neurosciences de Montpellier (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Retiveau, Nolwenn |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_treatment
Analgesic MESH: Analgesia Patient-Controlled MESH: Analgesics Opioid MESH: Anesthetics Local MESH: Length of Stay law.invention Sufentanil 03 medical and health sciences 0302 clinical medicine MESH: Saline Solution Randomized controlled trial 030202 anesthesiology Interquartile range law medicine MESH: Arthroplasty Replacement Hip MESH: Double-Blind Method MESH: Pain Postoperative MESH: Treatment Outcome MESH: Aged MESH: Middle Aged MESH: Humans [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology Ropivacaine business.industry Quadratus lumborum muscle MESH: Nerve Block Arthroplasty MESH: Prospective Studies MESH: Ropivacaine MESH: Male MESH: Morphine Anesthesiology and Pain Medicine Anesthesia Morphine business MESH: Female [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Anesthesiology Anesthesiology, Lippincott, Williams & Wilkins, 2021, 134 (5), pp.722-733. ⟨10.1097/ALN.0000000000003745⟩ |
| ISSN: | 1528-1175 0003-3022 |
| DOI: | 10.1097/aln.0000000000003745 |
| Popis: | BackgroundPain management is important for ensuring early mobilization after hip arthroplasty; however, the optimal components remain controversial. Recently, the quadratus lumborum block has been proposed as an analgesic option. The current study tested the hypothesis that the posterior quadratus lumborum block combined with multimodal analgesia decreases morphine consumption after hip arthroplasty.MethodsThis study was a prospective, randomized, double-blind, placebo-controlled trial. Before general anesthesia, 100 participating patients scheduled for elective total hip arthroplasty were randomly allocated to receive a 30-ml injection posterior to the quadratus lumborum muscle with either 0.33% ropivacaine (n = 50) or normal saline (n = 50). For all patients, multimodal analgesia included systematic administration of acetaminophen, ketoprofen, and a morphine intravenous patient-controlled analgesia. The primary outcome was total intravenous morphine consumption in the first 24 h. Secondary outcomes recorded intraoperative sufentanil consumption; morphine consumption in the postanesthesia care unit; pain scores at extubation and at 2, 6, 12, and 24 h; motor blockade; time to first standing and ambulation; hospital length of stay; and adverse events.ResultsThere was no significant difference in the 24-h total morphine consumption (ropivacaine group, median [interquartile range], 13 [7 to 21] versus saline group, 16 [9 to 21] mg; median difference, −1.5; 95% CI, −5 to 2; P = 0.337). Pain scores were not different between the groups (β = −0.4; 95% CI, −0.9 to 0.2; P = 0.199). There was no statistical difference between the two groups in intraoperative sufentanil consumption, morphine consumption in the postanesthesia care unit, motor blockade, times to first standing (median difference, 0.83 h; 95% CI, −1.7 to 3.4; P = 0.690) and ambulation (median difference, −1.85 h; 95% CI, −4.5 to 0.8; P = 0.173), hospital length of stay, and adverse events.ConclusionsAfter elective hip arthroplasty, neither morphine consumption nor pain scores were reduced by the addition of a posterior quadratus lumborum block to a multimodal analgesia regimen.Editor’s PerspectiveWhat We Already Know about This TopicWhat This Article Tells Us That Is New |
| Databáze: | OpenAIRE |
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