الفهرس 
Mohammed Mahmoud MaaroufOnly 14 pages are availabe for public view
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Abstract
H
ip fractures rate increased those days and postoperative pain control. The goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using multimodal analgesic therapy, preference for regional techniques, avoidance of sedatives, non-invasive ventilation with supplemental oxygen and early mobilization. The main advantage of quadratus lumborum block (QLB) compared to Spinal anaesthesia is the extension of local anesthetic agent beyond the transverses abdominis plane to the thoracic paravertebral space. The wider spread of the local anesthetic agents may produce extensive analgesia and prolonged action of the injected local anesthetic solution.
The aim of this study was to assess the analgesic efficacy of ultrasound-guided trans-muscular QLB compared with spinal anaesthesia during Hip surgery and in the early postoperative period regarding pain relief, provision of comfort, and improved respiratory functions.
After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients were included in the study, and were divided into two groups (n=32; each); group QLB and group spinal.
• group QLB: Patients (n=32) of this group received ultrasound-guided QLB before induction of spinal anesthesia using 0.2 ml/kg bupivacaine 0.25%.
• group Spinal Anaesthesia alone: Patients (n=32) of this group received Spinal anaesthesia alone, 3.5 ml of 0.5% bupivacaine plus 25 µg fentanyl.
The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first call for rescue analgesia. Demographic data, post-operative hemodynamics, and sedation score were also assessed.