Analgesic Efficacy of Quadro-Iliac Plane Block Versus Erector Spinae Plane in Total Hip Arthroplasty

This study aims to compare the Quadro-Iliac Plane Block versus Erector Spinae Plane Block after total hip arthroplasty.

Total hip arthroplasty (THA) is frequently utilized in elderly patients to address hip pain and restore joint function. Effective postoperative pain management is critical; however, the use of opioids is associated with a range of adverse effects, including nausea, vomiting, pruritus, constipation, respiratory depression, and the risk of dependence. Quadro-iliac plane block (QIPB) has been introduced, combining elements of both posterior and anterior QLB approaches. Erector Spinae Plane Block (ESPB) was initially described as an analgesic approach for managing thoracic neuropathic pain. This innovative fascial block technique enables sensory blockade across multiple abdominal and thoracic wall segments.

Inclusion Criteria: * Age ≥ 18 years. * Both sexes. * American Society of Anesthesiology (ASA) physical status I-III. * Undergoing total hip arthroplasty (THA) under spinal anesthesia. Exclusion Criteria: * History of allergies to local anesthetics. * Opioid dependency. * Body mass index (BMI) \> 35 kg/m2. * Cognitive impairment. * Bleeding or coagulation disorders. * Psychiatric and neurological disorder. * Local infection at the site of injection. * Severe heart, lung, liver, and renal dysfunction. * Emergency surgery.