• Onur Balaban, Ali Eman, Onur Palabiyik, and Alauddin Kochai.
• Department of Anesthesiology and Reanimation, Faculty of Medicine, Sakarya University, Sakarya, Turkiye.
• J Coll Physicians Surg Pak. 2025 Jan 1; 35 (1): 5105-10.

ObjectiveTo compare the postoperative analgesic effectiveness of ultrasound-guided lumbar erector spinae plane (LESP) block with lumbar plexus block (LPB) in patients operated for proximal femur fractures.Study DesignA randomised controlled trial. Place and Duration of the Study: Sakarya Training and Research Hospital Operation Theatre, Sakarya, Turkiye, between January and June 2023.MethodologyPatients undergoing proximal femur fracture surgery were randomised to receive either an LESP block or an LPB block. The primary outcome was 24 hour opioid consumption, which was given via a standard patient-controlled analgesia protocol. The secondary outcome was postoperative pain scores (numerical rating scale between 0 and 10) at the 30th minute, 2nd, 6th, 12th, and 24th hour time points. Mann-Whitney U test was used to compare the primary and secondary outcomes.ResultsA total of 64 patients were randomised, and 53 were analysed (25 patients in the LESP group and 28 patients in the LPB group). Demographic data were comparable between the groups. Mean NRS pain scores in 30th minute, 2nd, 6th, 12th, and 24th hours were 0.7 ± 1.3, 1.2 ± 1.8, 2.2 ± 2.3, 1.8 ± 1.9, and 1.9 ± 2.0 in the LESP group and 0.5 ± 1.0, 1.1 ± 1.8, 1.6 ± 1.9, 1.9 ± 1.9, and 1.6 ± 1.7 in the LPB group, respectively without significant difference. No significant differences were observed in fentanyl consumption between the LESP group (183.6 ± 171.7µg) and LPB group (131.1 ± 113.3µg, p = 0.415).ConclusionSingle injection LESP block provided satisfactory postoperative analgesia and comparable opioid consumption without a major complication. Therefore, the LESP block is an effective method for hip fracture surgery as a strong alternative to the LPB.Key WordsLumbar erector spinae plane block, Lumbar plexus block, Ultrasound-guided, Hip surgery, Femur fracture, Postoperative analgesia.

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