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

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 1(st), 3(rd) and 6(th) 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.