Background and Aims In hip dislocation surgery, adequate analgesia is crucial for early rehabilitation. Anterior quadratus lumborum block (AQLB) may be superior to caudal epidural block (CB) for analgesia in hip surgery with fewer complications. In this study, we aimed to confirm superiority of AQLB compared to CB in children for analgesia in open hip surgery.
Methods We conducted a double-blind study with 40 patients aged 2-7 years, undergoing unilateral open hip surgery and randomized into two groups. Ultrasound blocks were performed using 1 ml/kg Ropivacaine 0.2%. all patients had Paracetamol every six hours. Tramadol was planned as rescue analgesia when CHEOPS score was >6(2mg/kg). The primary outcome was the total consumption of analgesics in the first 24 postoperative hours. Secondary outcomes included time to realize block, intraoperative fentanyl consumption, occurrence of intraoperative tachycardia or hypertension, postoperative pain scores, time to first analgesic rescue and total dose of postoperative analgesic consumption.
The two groups were comparable No difference was noted in the time to perform the block(p=0.17). The consumption of intraoperative fentanyl was similar between the groups (p=0.36) with no difference in intraoperative hemodynamic parameters. We noted no differences in pain scores. The time to first analgesic rescue was similar (p=0.40). The postoperative total tramadol consumption in the CB group was 40±33 mg and 35±27 mg in the AQLB group(p=0.21).
Conclusions Our study showed that the AQLB and the CA were comparable regarding intra- and postoperative analgesic demand.
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