Quadratus lumborum block versus fascia iliaca compartment block for acetabular fracture surgery by Stoppa method: A double-blind prospective randomized controlled clinical trial

Abstract

Abstract Background: Acetabular fracture surgeries are frequently associated with long and severe perioperative pain, and there is no consensus on pain relief management. Aim: The purpose of this study was to compare the analgesic efficacy of fascia iliaca compartment block (FICB) and quadratus lumborum block (QLB) in patients with acetabular fractures undergoing surgery using the Stoppa method. Methods: Adult patients undergoing spinal anesthesia for acetabular fracture surgery were divided into two groups of FICB (n = 22) and QLB (n = 24) in this prospective double-blind randomized parallel clinical study. The pain intensity at different times was evaluated in all participants using the visual analog scale (VAS). The dose of fentanyl required to make the patient sit for spinal anesthesia and the pain intensity was evaluated. The duration of analgesia and the total amount of morphine consumed in the first 24 hours after surgery were also evaluated, analyzed, and compared between the two study groups. Results: Both FICB and QLB showed effective comparative postoperative analgesic profiles after acetabular fracture surgery; However, no significant variation in VAS values was found at any time of the study between the two groups. FICB showed decreased cumulative fentanyl consumption during spinal anesthetic placement, however, QLB had considerably lower total morphine demand in the initial postoperative 24h period. Conclusion: The lateral QLB and FICB can introduce as effective routes for analgesia in acetabular fracture surgery by the Stoppa approach. Clinical Trial Registration: The study was retrospectively registered in the clinical trials registry system, on 2021-02-17, with registration number: IRCT20191114045435N1.