Journal of AdvancedMedical and Dental Sciences Research

Background: Hip pain due to osteoarthritis is a leading indication for hip arthroplasty and is most common joint replacement surgery second to knee arthroplasty. Postoperative pain has several detrimental effects in postoperative recovery and rehabilitation of these patients. Quadratus Lumborum (QL) block is an emerging modality for postoperative analgesia. Aim: The aim of our study was to retrospectively analyse effectiveness of QL block in providing postoperative analgesia, its opioid sparing effect and to see if it contributes to early rehabilitation and shorter length of hospital stay. Settings and design: Retrospective study in the setting of a tertiary care hospital with surgeries done by a single surgeon. Material & Methods: Medical records of 78 patients who underwent total hip arthroplasty by a single surgeon were reviewed. 39 of these patients underwent QL block postoperatively in the operation theatre for postoperative analgesia and 39 patients were managed with other modalities of pain management. Record was made of pain assessment with visual analogue score (VAS) for first 24 hours, opioid consumption, time to mobilisation for rehabilitation and length of hospital stay. Results : The mean pain score was comparable on arrival in postoperative ward in both the groups 2.46 for group Q and 2.52 for the group N. Pain scores subsequently at 6, 12 and 18 hours were significantly lower in group Q compared to group N (p value <0.05). Mean morphine equivalent consumption in 24 hours was 11.88 ± 6.84 mg in group Q and 29.16 ± 11.62 mg in group N which was statistically significant. Time to mobilisation was significantly less in group Q ,18.68 ± 4.62 hours compared to group N 24.32 ± 5.36 hours. There was no significant difference in length of hospital stay in either group. Conclusion: Ultrasound guided QL3 block is a safe and effective postoperative pain management strategy after total hip arthroplasty which appears to facilitates early mobilization and rehabilitation. Key words: QL block, Hip Arthroplasty, Postoperative analgesia.