Comparison of pericapsular nerve group and lateral quadratus lumborum blocks on cumulative opioid consumption after primary total hip arthroplasty: a randomized controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
Epub Ahead of Print
Reg Anesth Pain Med. 2026 01-Jan;():. 10.1136/rapm-2024-105875What this means for my practice?
Lateral quadratus lumborum block resulted in lower cumulative opioid use between 36–72 hours after total hip arthroplasty compared with PENG + LFC block, with similar functional recovery outcomes. These findings support the use of QLB as an effective opioid-sparing regional anesthesia strategy in enhanced recovery pathways for THA. A limitation is that multimodal analgesia and periarticular injections were used in both groups, which may confound the independent effect of the nerve blocks.
Study Summary
One hundred and six patients with hip osteoarthritis undergoing primary total hip arthroplasty were randomized to receive a pericapsular nerve group block with lateral femoral cutaneous nerve block (n=53) or a lateral quadratus lumborum block (n=53). The primary outcome of interest was cumulative opioid consumption (intravenous morphine milligram equivalents). Secondary outcomes of interest included postoperative pain scores, time to ambulation, length of stay, and patient-reported functional outcomes (HOOS JR and PROMIS-10). Outcomes were assessed up to 72 hours postoperatively, with additional functional follow-up at 1 week, 2 weeks, and 6 weeks. Overall, the results of the study revealed that the lateral quadratus lumborum block resulted in significantly lower cumulative opioid consumption between 60–72 hours and lower pain scores with movement compared with the pericapsular nerve group block with lateral femoral cutaneous nerve block. These findings suggest that lateral QLB may provide superior opioid-sparing analgesia following total hip arthroplasty.
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