ArticleCureus2026
Efficacy and Safety of Ultrasound-Guided Transmuscular Quadratus Lumborum Block as an Adjunct to Local Infiltration Analgesia After Primary Total Hip Arthroplasty: A Retrospective Before-After Comparative Study.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTotal hip arthroplasty (THA) is associated with substantial postoperative pain, which can delay early mobilization and recovery. Quadratus lumborum block (QLB), originally developed for abdominal surgery, has been adapted for hip procedures; however, the clinical benefit and safety of the transmuscular approach (QLB3) remain uncertain. We aimed to evaluate the efficacy and safety of QLB3 in patients undergoing THA.
methodsWe conducted a single-center retrospective cohort study of 93 patients (100%) who underwent primary THA at our institution between February 2021 and February 2022. Patients received QLB3 plus local infiltration analgesia (LIA) (QLB3+LIA group, n = 45 (51.6%)) or LIA alone (LIA group, n = 48 (48.4%)). The primary outcome was postoperative pain intensity assessed using the numeric rating scale at 24 and 48 hours. Secondary outcomes included intravenous patient-controlled analgesia (IV-PCA) consumption within 48 hours and the incidence of postoperative nausea and vomiting (PONV) within 48 hours.
resultsBaseline demographic and surgical characteristics were similar between groups. Mean (SD) pain scores were lower in the QLB3+LIA group at 24 hours (2.4 ± 1.6 vs. 4.2 ± 2.1) and 48 hours (2.4 ± 2.0 vs. 4.3 ± 2.1). IV-PCA consumption within 48 hours was lower in the QLB3+LIA group (10.1 ± 13.2 mL) than in the LIA group (19.7 ± 20.8 mL). PONV occurred less frequently in the QLB3+LIA group (6/45 (13.3%)) than in the LIA group (16/48 (33.3%)). No block-related complications, including nerve palsy, were observed.
conclusionsQLB3 combined with LIA was associated with reduced postoperative pain, lower IV-PCA consumption, and fewer PONV events after THA, without observed neurologic complications. These findings support the use of QLB3 as part of multimodal analgesia and warrant confirmation in prospective randomized trials.
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