Comparison of fascia iliaca block with quadratus lumborum block for hip arthroplasty: A meta-analysis of randomized controlled trials

Abstract

Background: The efficacy of fascia iliaca block (FIB) versus quadratus lumborum block (QLB) remains controversial for pain management of hip arthroplasty. We conduct a systematic review and meta-analysis to explore the influence of FIB versus QLB on the postoperative pain intensity of hip arthroplasty. Methods: We have searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases through July 2023 for randomized controlled trials assessing the effect of FIB versus QLB on pain control of hip arthroplasty. This meta-analysis is performed using the random-effect model or fixed-effect model based on the heterogeneity. Results: Four randomized controlled trials and 234 patients were included in the meta-analysis. Overall, compared with QLB for hip arthroscopy, FIB was associated with substantially lower pain scores at 2 hours (mean difference [MD] = –0.49; 95% CI = –0.63 to –0.35; P < .00001) and pain scores at 12 hours (MD = –0.81; 95% CI = –1.36 to –0.26; P = .004), but showed no impact on pain scores at 24 hours (MD = –0.21; 95% CI = –0.57 to 0.15; P = .25), time to first rescue analgesia (standard mean difference = 0.70; 95% CI = –0.59 to 1.99; P = .29), analgesic consumption (MD = –4.80; 95% CI = –16.57 to 6.97; P = .42), or nausea and vomiting (odd ratio = 0.66; 95% CI = 0.32–1.35; P = .25). Conclusions: FIB may be better than QLB for pain control after hip arthroplasty, as evidenced by the lower pain scores at 2 and 24 hours.