Postoperative Analgesic Effects of the Quadratus Lumborum Block III and Transversalis Fascia Plane Block in Paediatric Patients with Developmental Dysplasia of the Hip Undergoing Open Reduction Surgeries: a Double-blinded Randomised Controlled Trial

Overview

Journal BMJ Open

Specialty General Medicine

Date 2021 Feb 5

PMID 33542037

Citations 4

Authors

Congcong Huang

Xiaoguang Zhang

Chaoxuan Dong

Chunwei Lian

Jun Li

Lingzhi Yu

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the analgesic effectiveness of two novel regional nerve blocks in paediatric patients with developmental dysplasia of the hip (DDH) after open reduction surgeries.

Design: Prospective, double-blinded, randomised controlled trial.

Setting: 2 tertiary teaching hospitals in China between August 2017 and July 2018.

Participants: 110 paediatric patients aged 2-10 years with DDH undergoing open reduction surgeries were recruited, 95 were randomised and 90 were included in the final analysis.

Interventions: Random assignment to quadratus lumborum block III (QLB III) group, transversalis fascia plane block (TFPB) group and the control (no region nerve block) group.

Primary And Secondary Outcome Measures: The primary outcome was the Face, Legs, Activity, Cry and Consolability (FLACC) Scale Scores. Secondary outcomes included perioperative opioid consumption, the time until first press of nurse-controlled analgesia/patient-controlled analgesia (NCA/PCA) pump and the total counts number of pressing, length of postanaesthesia care unit (PACU) stay, length of hospital stay, parental satisfaction with pain management and adverse events.

Results: Mean FLACC Scores were significantly lower in QLB III group and TFPB group while in the PACU and for 48 hours postoperatively, compared with control group (p<0.0001, p<0.0001, respectively). No differences were found for FLACC Scores between QLB III group and TFPB group, neither at rest (p=0.0402) nor while posture changing (p=0.0306). TFPB prolonged the first-time request for NCA/PCA analgesia, and decreased the total number of pressing counts, compared with QLB III (22.5 (16.2 to 28.7) vs 11.7 (6.6 to 16.8), p<0.0001; 2.4 (1.3 to 3.6) vs 3.8 (2.8 to 4.8), p=0.0111, respectively). No patient experienced any adverse events.

Conclusions: We suggested that both ultrasound-guided QLB III and TFPB should be considered as an option for perioperative analgesia in children with DDH undergoing open reduction surgeries. TFPB was superior to the QLB III because it prolonged the first-time request for NCA/PCA analgesia and decreased the total counts number of pressing.

Trial Registration Number: NCT03189966/2017.

Citing Articles

Postoperative Analgesic Effects of Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Pediatric Lower Abdominal Surgeries: A Systematic Review and Meta-Analysis.

Aldalati A, Hussein A, Ataya R, Alrabadi B, Odat R, Idrees M J Pain Res. 2025; 18:567-577.

PMID: 39926192 PMC: 11806731. DOI: 10.2147/JPR.S502044.

Efficacy and safety of various regional nerve blocks for postoperative analgesia in paediatric patients undergoing developmental dysplasia of the hip surgery: a protocol for systematic review and network meta-analysis.

Zhang Y, Fu C, Junxia W, Yang L, Qin Z BMJ Open. 2025; 14(12):e089194.

PMID: 39806655 PMC: 11667397. DOI: 10.1136/bmjopen-2024-089194.

Postoperative analgesic effects of the quadratus lumborum block in pediatric patients: a systematic review and meta-analysis.

Park I, Park J, Shin H, Na H, Koo B, Ryu J Korean J Pain. 2023; 37(1):59-72.

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Yayik A, Celik E, Aydin M, Ahiskalioglu E, Dost B, Altiparmak B Eurasian J Med. 2023; .

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Ultrasound-guided transversalis fascia plane block for postoperative analgesia: A systematic review and meta-analysis.

Nair A, Dudhedia U, Rangaiah M, Borkar N Indian J Anaesth. 2023; 67(4):331-342.

PMID: 37303881 PMC: 10248896. DOI: 10.4103/ija.ija_43_23.

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