This study aims to evaluate and compare the postoperative analgesic efficacy, opioid consumption, motor function preservation, and quality of recovery of ultrasound-guided Quadroiliac Plane Block (QIPB) versus transmuscular quadratus lumborum block (QLB) in patients undergoing THA under spinal anesthesia.
Age 18-75 years.
Both sexes.
American Society of Anesthesiologists (ASA) classification I-III.
Scheduled for elective primary unilateral total hip arthroplasty under spinal anesthesia.
Allergy to local anesthetics.
Infection at the injection site.
Coagulopathy or bleeding disorders.
Neuromuscular disorders.
Parallel
Quadroiliac Plane Block
DrugPatients will receive an ultrasound-guided Quadroiliac Plane Block (QIPB) using 20 mL of bupivacaine 0.25%.
Transmuscular quadratus lumborum block
DrugPatients will receive ultrasound-guided quadratus lumborum block (QLB) (transmuscular approach) using 20 mL of 0.25% bupivacaine.
Total morphine consumption
Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.
Degree of pain
Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 12, and 24 h postoperatively.
Time to the 1st rescue analgesia
Time to the first request for rescue analgesia will be recorded from the end of block to first dose of morphine administrated.
Time for ambulation
Time to ambulation: the time interval (in hours) from the end of surgery to the first successful mobilization of the patient, defined as the ability to stand and walk at least 3-5 steps with or without assistance.
Length of hospital stay
Length of hospital stay will be recorded from admission till the discharge from hospital.
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