Evidence map›Paper›PMID 41188948›Full record

Trial reportTrials2025

Efficacy and safety of combined lumbar plexus and quadratus lumborum block via Shamrock approach at L3 in total hip arthroplasty: a prospective randomized controlled trial.

Xiaofeng Wang, Junfeng Zhang, Zhenwei Xie, Yongzhu Chen, Yonglin-Chen, Zhenghuan Rao, Hui Zhang

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04266236 (Ultrasound-guided Lumbar Plexus Combined with Quadratus Lumborum Block Using Single-needle Technique with Shamrock Method for Hip Arthroplasty), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04266236 nacompletednot on this map

Ultrasound-guided Lumbar Plexus Combined with Quadratus Lumborum Block Using Single-needle Technique with Shamrock Method for Hip Arthroplasty

TypeinterventionalSponsorShanghai 6th People's HospitalRan2020 to 2024Enrolled84ConditionsHip Osteoarthritis, Anesthesia, Local, Hip Fractures, Osteonecrosis of Femoral HeadArmsL3 LPB, L4 LPB, T12 block, L3 QLB, 0.375%ropivacaine 25 ml (Raropin)
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Xiaofeng Wang *Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, No.600 Yishan Road, Shanghai, 200233, China.ORCID http://orcid.org/0000-0002-4184-0749
Junfeng Zhang *Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Tongren Hospital, Changning District, No. 1111 Xianxia Road, Shanghai, 200336, China.
Zhenwei XieDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, No.600 Yishan Road, Shanghai, 200233, China.
Yongzhu ChenDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, No.600 Yishan Road, Shanghai, 200233, China.
Yonglin-ChenDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, No.600 Yishan Road, Shanghai, 200233, China.
Zhenghuan RaoDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, No.600 Yishan Road, Shanghai, 200233, China.
Hui ZhangDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, No.600 Yishan Road, Shanghai, 200233, China. zhanghui@sjtu.edu.cn.ORCID http://orcid.org/0000-0003-0260-1793

Funding

Shanghai Municipal Health Commission 202340082
6 · The paper itself

Abstract

backgroundThis study aimed to evaluate the efficacy and safety of ultrasound-guided lumbar plexus block (LPB) combined with transmuscular quadratus lumborum block (TQLB) at the L3 level using the Shamrock approach for total hip arthroplasty.

methodsEighty-four patients were enrolled and randomly assigned into three groups at a 1:1:1 ratio: P group (LPB at L3 level), TP group (T12 paravertebral block combined with LPB at L3 and L4 levels) or PQ group (LPB combined with TQLB at L3 level). The primary outcome was the effective rate of sensory block, assessed via the cutaneous sensory block area. The secondary outcomes included postoperative pain intensity, intraoperative sufentanil consumption, incidence of hypotension, procedure time of block and complications.

resultsThe PQ group achieved a significantly higher effective rate of 67.6% compared to the P group, which was at 7.1% (p < 0.001), though lower than the TP group (89.3%, p = 0.051). The PQ group demonstrated significantly lower postoperative visual analogue scales (VAS) during movement compared to the P group (PACU: p = 0.009; 6 h: p = 0.046; 24 h: p = 0.006). However, no significant differences were observed between the PQ and TP groups under any condition (rest or movement). Sufentanil consumption remained comparable across the three groups. Notably, the PQ group experienced a lower frequency of intraoperative hypotension compared to the TP group (p = 0.028). Regarding procedure time, the PQ group exhibited a significantly lower mean value compared to the TP group, but it was higher than that in the P group (p < 0.001). Furthermore, no clinical signs of local anaesthetic systemic toxicity, nerve injury, haematoma or epidural block were observed in any of the groups.

conclusionsThe combined technique may provide effective block with fewer technical challenges and hypotension risks compared to multi-level LPB, making it a feasible alternative for perioperative pain management in total hip arthroplasty. Trial registration ClinicalTrials.gov, NCT04266236. Registered on 10 February 2020. CLINICALTRIALS: gov PRS: Record Summary NCT04266236.

Indexed as

Abdominal MusclesArthroplasty, Replacement, HipLumbosacral PlexusNerve BlockPostoperative PainAgedAnalgesics, OpioidFemaleHumansHypotensionMaleMiddle AgedPain MeasurementProspective StudiesSufentanilTime FactorsAnalgesics, OpioidSufentanilAnalgesiaHip arthroplastyLumbar plexus blockQuadratus lumborum blockShamrock approach

Identifiers

PMID41188948
PMCPMC12584387

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.