Evaluation of the effectiveness of quadratus lumborum block in postoperative analgesia in total hip replacement surgery

Aim: The primary aim of this study is; to investigate the effectiveness of Quadratus Lumborum Block (QLB-3) in postoperative analgesia, which is applied with USG in patients undergoing total hip replacement surgery. Material and Methods: In the planned total hip replacement operation under general anesthesia and in the pre-anesthetic evaluation; 60 patients between the ages of 18-75, with ASA classification Ⅰ-Ⅱ-Ⅲ, and signing informed consent form were included in the study. Patients were randomly divided into two groups using the closed envelope method. Groups were determined as the QLB group that was blocked (n=30) and the control group without block (n=30). PCA device containing fentanyl was used postoperatively in all cases, and infusion continued for 24 hours. Preoperative demographic data of the patients were recorded. In postoperative follow-up VAS values at 0th, 6th, 12th and 24th hours PCA and fentanyl consumption amounts, PCA and bolus counts, heart rate, systolic and diastolic blood pressures, presence of nausea and additional analgesic requirements were compared. Results: Demographic data of both groups were similar. Postoperative 6th, 12th and 24th hour VAS values, total fentanyl consumption for 24 hours with PCA and the number of bolus, additional dose analgesic requirement were statistically significantly higher in the control group. When the heart rate, systolic and diastolic blood pressure and presence of nausea were compared in the follow-up of the patients, no statistically significant difference was found. Conclusion: In our study, it was determined that transmuscular QLB decreased the amount of intravenous analgesic consumed in the first 24 hours postoperatively and decreased VAS values in patients who underwent total hip replacement surgery. We think that ultrasonography-guided QLB is an alternative, safe and effective method to provide postoperative analgesia and reduce opioid consumption in patients undergoing hip surgery. Therefore, QLB application can be an alternative to traditional analgesic methods. It was concluded that the number of patients and studies should increase due to the limited number of patients and clinical studies in the literature. Key Words: Quadratus Lumborum Block (QLB), Postoperative Analgesia, Hip Surgery