Anterior Quadratus Lumborum Block Does Not Provide Superior Pain Control after Hip Arthroscopy: A Double-blinded Randomized Controlled Trial
| Autor: | Bryan T. Kelly, Audrey Tseng, Jemiel A Nejim, Haoyan Zhong, Stavros G. Memtsoudis, Anil S. Ranawat, Marko Mamic, Danyal H. Nawabi, Struan H. Coleman, Stephen C. Haskins, Douglas S Wetmore, Stephanie I Cheng |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Arthroplasty Replacement Hip Sedation law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Patient satisfaction Double-Blind Method Randomized controlled trial 030202 anesthesiology law medicine Humans Pain Management Abdominal Muscles Bupivacaine Pain Postoperative business.industry Quadratus lumborum muscle Nerve Block Middle Aged Ketorolac Anesthesiology and Pain Medicine Anesthesia Ambulatory Female Hip arthroscopy medicine.symptom business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Anesthesiology. 135:433-441 |
| ISSN: | 1528-1175 0003-3022 |
| DOI: | 10.1097/aln.0000000000003853 |
| Popis: | Background Hip arthroscopy is associated with moderate to severe postoperative pain. This prospective, randomized, double-blinded study investigates the clinically analgesic effect of anterior quadratus lumborum block with multimodal analgesia compared to multimodal analgesia alone. The authors hypothesized that an anterior quadratus lumborum block with multimodal analgesia would be superior for pain control. Methods Ninety-six adult patients undergoing ambulatory hip arthroscopy were enrolled. Patients were randomized to either a single-shot anterior quadratus lumborum block (30 ml bupivacaine 0.5% with 2 mg preservative-free dexamethasone) or no block. All patients received neuraxial anesthesia, IV sedation, and multimodal analgesia (IV acetaminophen and ketorolac). The primary outcome was numerical rating scale pain scores at rest and movement at 30 min and 1, 2, 3, and 24 h. Results Ninety-six patients were enrolled and included in the analysis. Anterior quadratus lumborum block with multimodal analgesia (overall treatment effect, marginal mean [standard error]: 4.4 [0.3]) was not superior to multimodal analgesia alone (overall treatment effect, marginal mean [standard error]: 3.7 [0.3]) in pain scores over the study period (treatment differences between no block and anterior quadratus lumborum block, 0.7 [95% CI, –0.1 to 1.5]; P = 0.059). Postanesthesia care unit antiemetic use, patient satisfaction, and opioid consumption for 0 to 24 h were not significantly different. There was no difference in quadriceps strength on the operative side between groups (differences in means, 1.9 [95% CI, –1.5 to 5.3]; P = 0.268). Conclusions Anterior quadratus lumborum block may not add to the benefits provided by multimodal analgesia alone after hip arthroscopy. Anterior quadratus lumborum block did not cause a motor deficit. The lack of treatment effect in this study demonstrates a surgical procedure without benefit from this novel block. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New |
| Databáze: | OpenAIRE |
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