Efficacy of a Modified Cocktail for Quadratus Lumborum Block Combined With Periarticular Local Infiltration Analgesia in Total Hip Arthroplasty.

Resumen del estudio

70 patients undergoing primary unilateral total hip arthroplasty (THA) were randomized to receive a quadratus lumborum block (QLB) combined with periarticular local infiltration analgesia (LIA) or LIA alone, using a modified analgesic cocktail containing ropivacaine, dexamethasone, magnesium sulfate, and sodium bicarbonate. The primary outcome was total opioid consumption within 24 hours postoperatively. Secondary outcomes included intraoperative opioid consumption, numerical rating scale (NRS) pain scores, quadriceps muscle strength, walking distance, Quality of Recovery-15 (QoR-15) scores, inflammatory markers, plasma ropivacaine concentrations, and adverse events. Clinical outcomes were assessed up to 72 hours postoperatively. Overall, the results revealed that QLB combined with LIA significantly reduced postoperative opioid consumption and pain during early mobilization compared with LIA alone, without significant improvements in functional recovery or inflammatory responses. These findings suggested that adding QLB to LIA improved early postoperative analgesia following THA, although the reduction in opioid consumption was below the predefined threshold for clinical importance.