Application of ultrasound-guided regional blocks in the perioperative period of hip arthroplasty: A systematic review and network meta-analysis
Authors' conclusion
No single regional block technique demonstrated superiority across all postoperative outcomes. Ultrasound-guided QLB was particularly effective in reducing morphine consumption, alleviating pain, and decreasing PONV. PAI and PENG also demonstrated efficacy in reducing postoperative pain and consumption of morphine.
Study context
- Population
- Patients undergoing total hip arthroplasty (THA)
- Participants
- 1,424 patients · 18 studies
- Comparison
- Ultrasound-guided regional blocks (lumbar plexus block (LPB), suprainguinal fascia iliaca block (SIFIB), PENG, femoral nerve block (FNB), fascia iliaca block (FIB), quadratus lumborum block (QLB), erector spinae plane block (ESPB)), periarticular injection (PAI) and saline control compared with each other
- Outcome
- Movement-evoked pain (MEP) and pain at rest (PAR) scores
- Follow-up
- Within 12 and 24 h postoperatively
Methodological detailsSearched PubMed, Cochrane Library, Web of Science and Embase up to December 9, 2024
- Searched PubMed, Cochrane Library, Web of Science and Embase up to December 9, 2024
Pooled result
As reported in the abstract
- Movement-evoked pain (MEP) scores significantly lower in PAI, PENG and QLB
- No significant differences in pain at rest (PAR) scores within 12 h or 24 h
Further pooled results
Morphine consumption within 24 h (bupivacaine subgroup)
- Lower morphine consumption with QLB
Morphine consumption during hospital stay
- Lowest morphine consumption with QLB
Postoperative nausea and vomiting (PONV)
- Regional blockade statistically significantly different from placebo control
Original publication
Application of ultrasound-guided regional blocks in the perioperative period of hip arthroplasty: A systematic review and network meta-analysis. J Clin Anesth. Published 27 December 2025. doi:10.
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