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ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 4  |  Page : 825-831

Comparison of ultrasound-guided lumbar erector spinae plane block and transmuscular quadratus lumborum block for postoperative analgesia in hip and proximal femur surgery: A prospective randomized feasibility study


1 Department of Anesthesiology and Reanimation, Maltepe University Faculty of Medicine, Istanbul, Turkey
2 Department of Anesthesiology and Reanimation, Maltepe State Hospital, Istanbul, Turkey
3 Department of Medical Education, Maltepe University Faculty of Medicine, Istanbul, Turkey
4 Department of Orthopedic and Trauma Surgery, Maltepe University Faculty of Medicine, Istanbul, Turkey

Correspondence Address:
Dr. Serkan Tulgar
Maltepe Universitesi Hastanesi, Feyzullah Caddesi No: 39 Maltepe, Istanbul
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aer.AER_142_18

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Study Objective: Lumbar Erector spinae Plane block (L-ESPB) is a modification of a recently described block. Both L-ESPB and Transmuscular Quadratus Lumborum block (QLB-T) have been reported to provide effective postoperative analgesia in hip and proximal femur surgery. Herein, we compare the effectiveness of L-ESPB and QLB-T in providing postoperative analgesia in patients undergoing hip and femur operations. Design: Double-blinded, prospective, randomized, feasibility study. Setting: Tertiary university hospital, postoperative recovery room and ward. Methodology: A total of 72 patients (American Society of Anesthesiology physical status classification II-III) were recruited. After exclusion, 60 patients were allocated to three equal groups (control, L-ESB and QLB-t). Interventions: Standard multimodal analgesia was performed in the control group while L-ESPB or QLB-T was performed in the block groups. Measurements: Pain intensity between groups was compared using Numeric Rating Scores. Furthermore, tramadol consumption and additional rescue analgesic requirement was measured. Results: There was no difference between demographic data or type of surgery. While there was no difference in Numeric Rating Scale (NRS) score at any hour between the block groups; NRS scores at the 1st, 3rd and 6th h, tramadol consumption during the first 12 h and total tramadol consumption, the number of patient required rescue analgesic in 24 h were significantly higher in the control group compared to both block groups. Conclusion: While L-ESPB and QLB-T have similar effect, they improve analgesia quality in patients undergoing hip and proximal femoral surgery when compared to standard intravenous analgesia regimen.


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