Ultrasound-Guided Transmuscular Quadratus Lumborum Block Reduces Postoperative Pain Intensity in Patients Undergoing Total Hip Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial
Background and Objectives. Pain management following total hip arthroplasty (THA) has been widely investigated; however, the best effective method is yet to be determined. The aim of this prospective, placebo-controlled study was to evaluate the analgesic efficacy of ultrasound-guided QL3 block in p...
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Published in | Pain research & management Vol. 2020; no. 2020; pp. 1 - 8 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Cairo, Egypt
Hindawi Publishing Corporation
2020
Hindawi John Wiley & Sons, Inc Hindawi Limited |
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Abstract | Background and Objectives. Pain management following total hip arthroplasty (THA) has been widely investigated; however, the best effective method is yet to be determined. The aim of this prospective, placebo-controlled study was to evaluate the analgesic efficacy of ultrasound-guided QL3 block in patients undergoing THA. Methods. Eighty-eight patients undergoing THA were randomized to receive 0.33% ropivacaine (Group QLB, n = 44) or saline (Group Con, n = 44) for QL3 block. Spinal anesthesia was then performed. Pain intensity was assessed using the visual analog scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on standing and walking at 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, the 10-meter walking speed on day 6, and patient satisfaction after surgery. Results. Postoperative pain intensity was significantly lower in Group QLB compared to Group Con at rest after 3, 6, 12, 24, 36, and 48 h (p<0.001) and during mobilization after 24, 36, and 48 h (p<0.001). Morphine use was significantly lower in Group QLB compared to Group Con during 0–24 h (16.0 ± 7.1 vs. 34.1 ± 7.1 mg, p<0.001) and during 24–48 h (13.0 ± 4.0 vs. 17.4 ± 4.6 mg, p<0.001) postoperatively. The 10-meter walking speed was higher in Group QLB compared to Group Con, both at comfortable (0.79 ± 0.13 vs. 0.70 ± 0.14 m/s, p=0.012) and at maximum speeds (1.18 ± 0.26 vs. 1.06 ± 0.22 m/s, p<0.001). Incidences of nausea (7.3% vs. 31%, p=0.006), vomiting (7.3% vs. 26.2%, p = 0.022), and urinary retention (9.8% vs. 28.6%, p=0.030) were lower in Group QLB than in Group Con. Conclusions. Ultrasound-guided QL3 block is an effective pain management technique after THA. |
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AbstractList | Background and Objectives. Pain management following total hip arthroplasty (THA) has been widely investigated; however, the best effective method is yet to be determined. The aim of this prospective, placebo-controlled study was to evaluate the analgesic efficacy of ultrasound-guided QL3 block in patients undergoing THA. Methods. Eighty-eight patients undergoing THA were randomized to receive 0.33% ropivacaine (Group QLB, n = 44) or saline (Group Con, n = 44) for QL3 block. Spinal anesthesia was then performed. Pain intensity was assessed using the visual analog scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on standing and walking at 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, the 10-meter walking speed on day 6, and patient satisfaction after surgery. Results. Postoperative pain intensity was significantly lower in Group QLB compared to Group Con at rest after 3, 6, 12, 24, 36, and 48 h (p<0.001) and during mobilization after 24, 36, and 48 h (p<0.001). Morphine use was significantly lower in Group QLB compared to Group Con during 0–24 h (16.0 ± 7.1 vs. 34.1 ± 7.1 mg, p<0.001) and during 24–48 h (13.0 ± 4.0 vs. 17.4 ± 4.6 mg, p<0.001) postoperatively. The 10-meter walking speed was higher in Group QLB compared to Group Con, both at comfortable (0.79 ± 0.13 vs. 0.70 ± 0.14 m/s, p=0.012) and at maximum speeds (1.18 ± 0.26 vs. 1.06 ± 0.22 m/s, p<0.001). Incidences of nausea (7.3% vs. 31%, p=0.006), vomiting (7.3% vs. 26.2%, p = 0.022), and urinary retention (9.8% vs. 28.6%, p=0.030) were lower in Group QLB than in Group Con. Conclusions. Ultrasound-guided QL3 block is an effective pain management technique after THA. Background and Objectives. Pain management following total hip arthroplasty (THA) has been widely investigated; however, the best effective method is yet to be determined. The aim of this prospective, placebo-controlled study was to evaluate the analgesic efficacy of ultrasound-guided QL3 block in patients undergoing THA. Methods. Eighty-eight patients undergoing THA were randomized to receive 0.33% ropivacaine (Group QLB, n = 44) or saline (Group Con, n = 44) for QL3 block. Spinal anesthesia was then performed. Pain intensity was assessed using the visual analog scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on standing and walking at 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, the 10-meter walking speed on day 6, and patient satisfaction after surgery. Results. Postoperative pain intensity was significantly lower in Group QLB compared to Group Con at rest after 3, 6, 12, 24, 36, and 48 h (p < 0.001) and during mobilization after 24, 36, and 48 h (p < 0.001). Morphine use was significantly lower in Group QLB compared to Group Con during 0-24h (16.0 [+ or -] 7.1 vs. 34.1 [+ or -] 7.1 mg, p < 0.001) and during 24-48 h (13.0 [+ or -] 4.0 vs. 17.4 [+ or -] 4.6 mg, p < 0.001) postoperatively. The 10-meter walking speed was higher in Group QLB compared to Group Con, both at comfortable (0.79 [+ or -]0.13 vs. 0.70 [+ or -] 0.14m/s, p = 0.012) and at maximum speeds (1.18 [+ or -] 0.26 vs. 1.06 [+ or -] 0.22 m/s, p < 0.001). Incidences of nausea (7.3% vs. 31%, p = 0.006), vomiting (7.3% vs. 26.2%, p = 0.022), and urinary retention (9.8% vs. 28.6%, p = 0.030) were lower in Group QLB than in Group Con. Conclusions. Ultrasound-guided QL3 block is an effective pain management technique after THA. Background and Objectives . Pain management following total hip arthroplasty (THA) has been widely investigated; however, the best effective method is yet to be determined. The aim of this prospective, placebo-controlled study was to evaluate the analgesic efficacy of ultrasound-guided QL3 block in patients undergoing THA. Methods . Eighty-eight patients undergoing THA were randomized to receive 0.33% ropivacaine (Group QLB, n = 44) or saline (Group Con, n = 44) for QL3 block. Spinal anesthesia was then performed. Pain intensity was assessed using the visual analog scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on standing and walking at 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, the 10-meter walking speed on day 6, and patient satisfaction after surgery. Results . Postoperative pain intensity was significantly lower in Group QLB compared to Group Con at rest after 3, 6, 12, 24, 36, and 48 h ( p < 0.001 ) and during mobilization after 24, 36, and 48 h ( p < 0.001 ). Morphine use was significantly lower in Group QLB compared to Group Con during 0–24 h (16.0 ± 7.1 vs. 34.1 ± 7.1 mg, p < 0.001 ) and during 24–48 h (13.0 ± 4.0 vs. 17.4 ± 4.6 mg, p < 0.001 ) postoperatively. The 10-meter walking speed was higher in Group QLB compared to Group Con, both at comfortable (0.79 ± 0.13 vs. 0.70 ± 0.14 m/s, p = 0.012 ) and at maximum speeds (1.18 ± 0.26 vs. 1.06 ± 0.22 m/s, p < 0.001 ). Incidences of nausea (7.3% vs. 31%, p = 0.006 ), vomiting (7.3% vs. 26.2%, p = 0.022), and urinary retention (9.8% vs. 28.6%, p = 0.030 ) were lower in Group QLB than in Group Con. Conclusions . Ultrasound-guided QL3 block is an effective pain management technique after THA. Eighty-eight patients undergoing THA were randomized to receive 0.33% ropivacaine (Group QLB, = 44) or saline (Group Con, = 44) for QL3 block. Spinal anesthesia was then performed. Pain intensity was assessed using the visual analog scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on standing and walking at 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, the 10-meter walking speed on day 6, and patient satisfaction after surgery. Postoperative pain intensity was significantly lower in Group QLB compared to Group Con at rest after 3, 6, 12, 24, 36, and 48 h ( < 0.001) and during mobilization after 24, 36, and 48 h ( < 0.001). Morphine use was significantly lower in Group QLB compared to Group Con during 0-24 h (16.0 ± 7.1 vs. 34.1 ± 7.1 mg, < 0.001) and during 24-48 h (13.0 ± 4.0 vs. 17.4 ± 4.6 mg, < 0.001) postoperatively. The 10-meter walking speed was higher in Group QLB compared to Group Con, both at comfortable (0.79 ± 0.13 vs. 0.70 ± 0.14 m/s, =0.012) and at maximum speeds (1.18 ± 0.26 vs. 1.06 ± 0.22 m/s, < 0.001). Incidences of nausea (7.3% vs. 31%, =0.006), vomiting (7.3% vs. 26.2%, = 0.022), and urinary retention (9.8% vs. 28.6%, =0.030) were lower in Group QLB than in Group Con. Ultrasound-guided QL3 block is an effective pain management technique after THA. |
Audience | Academic |
Author | Wang, Han Bin Liu, Qi Xia Zheng, Xue Qin He, Wan You He, Jian Li, Dong Lin Zhang, Lei |
AuthorAffiliation | Department of Anesthesiology, The First People's Hospital of Foshan, Foshan City, China |
AuthorAffiliation_xml | – name: Department of Anesthesiology, The First People's Hospital of Foshan, Foshan City, China |
Author_xml | – sequence: 1 fullname: Wang, Han Bin – sequence: 2 fullname: Zheng, Xue Qin – sequence: 3 fullname: Li, Dong Lin – sequence: 4 fullname: He, Wan You – sequence: 5 fullname: Zhang, Lei – sequence: 6 fullname: He, Jian – sequence: 7 fullname: Liu, Qi Xia |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32256907$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_7759_cureus_57346 crossref_primary_10_1097_AJP_0000000000001059 crossref_primary_10_1155_2024_4518587 crossref_primary_10_1186_s13018_022_03172_8 crossref_primary_10_3389_fmed_2021_771859 crossref_primary_10_1186_s13063_023_07619_z crossref_primary_10_1016_j_anclin_2023_11_015 crossref_primary_10_4103_ija_ija_863_22 crossref_primary_10_7759_cureus_50119 crossref_primary_10_1111_ctr_14403 crossref_primary_10_7759_cureus_22287 crossref_primary_10_1111_anae_15823 crossref_primary_10_1016_j_anrea_2021_11_003 crossref_primary_10_1016_j_arth_2022_07_013 crossref_primary_10_1093_jhps_hnac020 crossref_primary_10_1097_ACO_0000000000001287 crossref_primary_10_1016_j_csm_2021_11_001 crossref_primary_10_1177_11207000221111309 crossref_primary_10_3389_fphar_2022_860106 |
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Copyright | Copyright © 2020 Jian He et al. COPYRIGHT 2020 John Wiley & Sons, Inc. Copyright © 2020 Jian He et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. http://creativecommons.org/licenses/by/4.0 Copyright © 2020 Jian He et al. 2020 |
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References | 22 23 24 25 26 27 28 29 (8) 2014; 80 (6) 2013; 71 30 10 11 12 13 14 15 16 17 18 19 1 2 3 4 5 7 9 20 21 |
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Snippet | Background and Objectives. Pain management following total hip arthroplasty (THA) has been widely investigated; however, the best effective method is yet to be... Eighty-eight patients undergoing THA were randomized to receive 0.33% ropivacaine (Group QLB, = 44) or saline (Group Con, = 44) for QL3 block. Spinal... Background and Objectives . Pain management following total hip arthroplasty (THA) has been widely investigated; however, the best effective method is yet to... |
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SubjectTerms | Analgesics Anesthesia Care and treatment Clinical Study Clinical trials Dexmedetomidine Double-blind studies Hip joint Hospitals Joint replacement surgery Joint surgery Medical research Narcotics Nonsteroidal anti-inflammatory drugs Pain Pain management Pain, Postoperative Patient satisfaction Patients Postoperative period Skin Statistical analysis Surgical techniques Ultrasonic imaging Walking |
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Title | Ultrasound-Guided Transmuscular Quadratus Lumborum Block Reduces Postoperative Pain Intensity in Patients Undergoing Total Hip Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial |
URI | https://search.emarefa.net/detail/BIM-1206674 https://dx.doi.org/10.1155/2020/1035182 https://www.ncbi.nlm.nih.gov/pubmed/32256907 https://www.proquest.com/docview/2381584765 https://pubmed.ncbi.nlm.nih.gov/PMC7085398 https://doaj.org/article/a61331241898436799996b41ee910e7e |
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