LAUSR

Background Pericapsular nerve group (PENG) block, quadratus lumborum block (QLB) and intra-articular (IA) local anesthetic injection have all been shown to provide effective analgesia in total hip arthroplasty (THA). The aim of this randomized study was to compare PENG block, QLB, and IA injection in terms of analgesic efficacy, motor protection, and quality of recovery. Methods A total of 89 patients who underwent unilateral primary THA under spinal anesthesia were randomly assigned to the groups of PENG block (n = 30), QLB (n = 30), and IA (n = 29). The primary outcome was the numerical rating scale (NRS) over 48 hours. Secondary outcomes were postoperative opioid use, quadriceps and adductor muscle strength, and quality of recovery (QoR-40). Results The 3-hour and 6-hour dynamic NRS scores were significantly different in the PENG and QLB group compared to the IA group (P = 0.002 and P < 0.001, respectively). The time to the first requirement for opioid analgesia was longer in the PENG and QLB groups than in the IA group (P = 0.009, P = 0.016, respectively). There was a significant difference between the PENG and QLB groups in terms of quadriceps muscle strength (QMS) at 3 hours (P = 0.007) and mobilization time (P = 0.003). There was no significant difference in QoR-40. Conclusions The PENG block and QLB showed more effective analgesia at 6 hours postoperatively compared to IA applications. The PENG block and QLB applications showed similar analgesic effects. All the groups were similar in terms of postoperative recovery.