Deep Iliacus Plane Block Versus Transmuscular Quadratus Lumborum Block for Postoperative Analgesia After Total Hip Arthroplasty

Deep Iliacus Plane Block Versus Transmuscular Quadratus Lumborum Block for Postoperative Analgesia After Total Hip Arthroplasty: A Randomized Clinical Trial

This study aims to compare the analgesic efficacy, opioid consumption, motor function preservation, and quality of recovery of ultrasound-guided deep iliacus plane block (DIPB) and transmuscular quadratus lumborum block (QLB) in patients undergoing total hip arthroplasty (THA).

Total hip arthroplasty (THA) is one of the most commonly performed orthopedic procedures for the treatment of end-stage hip disorders. It is indicated for conditions such as osteoarthritis, rheumatoid arthritis, avascular necrosis, and femoral neck fractures.

The quadratus lumborum block (QLB) is an ultrasound-guided fascial plane block that has been increasingly used for analgesia in hip surgery.

The deep iliacus plane block (DIPB) is a recently introduced regional anesthesia technique specifically developed for hip analgesia. The block is performed by depositing local anesthetic in the deep fascial plane between the iliacus muscle and the iliac bone.

Inclusion Criteria:

• Age ≥ 18 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I-III.
• Scheduled for elective unilateral total hip arthroplasty (THA) under spinal anesthesia.

Exclusion Criteria:

• Known allergy to local anesthetics or study medications.
• Coagulopathy or anticoagulant therapy contraindicating regional anesthesia.
• Infection at the site of injection.
• Pre-existing neurological deficits affecting the lower limbs.
• Chronic opioid use or opioid dependence.
• Severe hepatic, renal, respiratory, or cardiac disease.
• Body mass index (BMI) > 40 kg/m².
• Contraindications to spinal anesthesia.