Lumbar plexus blockade reduces pain after hip arthroscopy: a prospective randomized controlled trial

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Pain Management

Background:

• Hip arthroscopy frequently leads to moderate to severe postoperative pain.
• Effective pain management is crucial for same-day discharge protocols following hip arthroscopy.

Purpose of the Study:

• To evaluate the efficacy of a lumbar plexus block (LPB) in reducing postoperative pain in the postanesthesia care unit (PACU).
• To assess the impact of LPB on pain at rest and with movement, analgesic consumption, and patient satisfaction after hip arthroscopy.

Main Methods:

• Patients undergoing hip arthroscopy received a combined spinal epidural with sedation and analgesics.
• A subset of patients received a single-injection bupivacaine lumbar plexus block (LPB).
• Postoperative pain was managed with oral and IV analgesics as needed.

Main Results:

• The LPB demonstrated a statistically significant reduction in resting pain scores within the PACU (mean reduction of 0.9 on a 0-10 scale).
• No significant differences were observed in pain with movement, analgesic use, or patient satisfaction between groups.
• Two patients in the LPB group experienced falls in the PACU without injury; one LPB patient required admission for urinary retention.

Conclusions:

• Lumbar plexus block provides a statistically significant reduction in resting postoperative pain following hip arthroscopy.
• The limited impact on secondary outcomes suggests that the risks and benefits of LPB should be carefully individualized for each patient.