Quadratus Lumborum Block Vs Paravertebral Nerve Block For Total Hip Arthroplasty .
Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty.
Arch Orthop Trauma Surg . 2023 Nov;143(11):6849-6855.One hundred and sixty patients with osteoarthritis undergoing total hip arthroplasty were randomized to receive either a Quadratus Lumborum Type 3 Nerve Block (QLB; n=80) or a Paravertebral Nerve Block (PNB; n=80). Outcomes of interest were peri-operative opioid consumption, intra-operative peak systolic blood pressure, respiratory rate, post-operative lower extremity muscle weakness, and hospital length of stay. Outcomes were assessed up to hospital discharge. Overall, the results of the study revealed that the QLB group required significantly higher intra-operative narcotic use (p < 0.001) and exhibited higher incidences of post-operative lower extremity muscle weakness (p = 0.040). However, post-operative pain management and discharge times were similar between the two groups. Maximum systolic pressure and respiratory rates were significantly higher in the QLB group compared to the PNB group. These findings suggest that while QLB may necessitate more intra-operative opioids and lead to more motor weakness, it does not impact the overall discharge success rate.
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