{"id":142916,"date":"2025-10-24T14:37:16","date_gmt":"2025-10-24T14:37:16","guid":{"rendered":"https:\/\/www.europesays.com\/ie\/142916\/"},"modified":"2025-10-24T14:37:16","modified_gmt":"2025-10-24T14:37:16","slug":"the-efficacy-and-safety-of-peripheral-nerve-blocks-for-postoperative-analgesia-following-total-hip-arthroplasty-a-network-meta-analysis-bmc-anesthesiology","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/ie\/142916\/","title":{"rendered":"The efficacy and safety of peripheral nerve blocks for postoperative analgesia following total hip arthroplasty: a network meta-analysis | BMC Anesthesiology"},"content":{"rendered":"<p>Literature retrieval and screening process<\/p>\n<p>The initial literature search yielded 2,679 articles. After removing 1,115 duplicate records, the titles and abstracts of the remaining 1,564 articles were checked, and 1,510 articles were excluded. The full texts of the remaining articles were reviewed according to predetermined inclusion and exclusion criteria. Ultimately, 18 articles [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e914\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Kumar K, Pandey RK, Bhalla AP, Kashyap L, Garg R, Darlong V, et al. Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia Iliaca compartment block for postoperative analgesia in total hip arthroplasty. A prospective randomized study. Acta Anaesthesiol Belg. 2015;66(3):95\u2013100.\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR13\" id=\"ref-link-section-d41244769e917\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#10;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#10;                  &#10;                .\" href=\"#ref-CR30\" id=\"ref-link-section-d41244769e920\">30<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#10;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#10;                  &#10;                .\" href=\"#ref-CR31\" id=\"ref-link-section-d41244769e920_1\">31<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#10;                  &#10;                .\" href=\"#ref-CR32\" id=\"ref-link-section-d41244769e920_2\">32<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#10;                  &#10;                .\" href=\"#ref-CR33\" id=\"ref-link-section-d41244769e920_3\">33<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#10;                  https:\/\/doi.org\/10.3390\/jpm12030408&#10;                  &#10;                .\" href=\"#ref-CR34\" id=\"ref-link-section-d41244769e920_4\">34<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#10;                  https:\/\/doi.org\/10.2147\/lra.S350033&#10;                  &#10;                .\" href=\"#ref-CR35\" id=\"ref-link-section-d41244769e920_5\">35<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#10;                  &#10;                .\" href=\"#ref-CR36\" id=\"ref-link-section-d41244769e920_6\">36<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#10;                  https:\/\/doi.org\/10.4097\/kja.23064&#10;                  &#10;                .\" href=\"#ref-CR37\" id=\"ref-link-section-d41244769e920_7\">37<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#10;                  https:\/\/doi.org\/10.4097\/kja.22669&#10;                  &#10;                .\" href=\"#ref-CR38\" id=\"ref-link-section-d41244769e920_8\">38<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#10;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#10;                  &#10;                .\" href=\"#ref-CR39\" id=\"ref-link-section-d41244769e920_9\">39<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Iglesias SL, Nieto I, L\u00f3pez P, Almada A, Pioli I, Astore F, et al. Pericapsular nerves block (peng) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: a randomized clinical trial. Rev Esp Cir Ortop Traumatol. 2023;67(3):226\u201332. &#10;                  https:\/\/doi.org\/10.1016\/j.recot.2022.12.004&#10;                  &#10;                .\" href=\"#ref-CR40\" id=\"ref-link-section-d41244769e920_10\">40<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#10;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#10;                  &#10;                .\" href=\"#ref-CR41\" id=\"ref-link-section-d41244769e920_11\">41<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#10;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#10;                  &#10;                .\" href=\"#ref-CR42\" id=\"ref-link-section-d41244769e920_12\">42<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#10;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#10;                  &#10;                .\" href=\"#ref-CR43\" id=\"ref-link-section-d41244769e920_13\">43<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#10;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#10;                  &#10;                .\" href=\"#ref-CR44\" id=\"ref-link-section-d41244769e920_14\">44<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e923\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>] were included. The flowchart demonstrating the study selection is presented in Fig. <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig1\" rel=\"nofollow noopener\" target=\"_blank\">1<\/a>.<\/p>\n<p><b id=\"Fig1\" class=\"c-article-section__figure-caption\" data-test=\"figure-caption-text\">Fig. 1<\/b><a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2\/figures\/1\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig1\" src=\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/10\/12871_2025_3395_Fig1_HTML.png\" alt=\"figure 1\" loading=\"lazy\" width=\"685\" height=\"709\"\/><\/a>Baseline characteristics of included studies<\/p>\n<p>The 18 included studies were conducted in 12 countries (the United States, Argentina, Chile, China, Egypt, France, India, Ireland, Italy, Japan, Korea, and Turkey), involving a total of 1,180 patients. The study population comprised 556 males and 624 females, and the age of patients ranged from 41 to 72 years. Among these, 10 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR33\" id=\"ref-link-section-d41244769e956\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 34\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#010;                  https:\/\/doi.org\/10.3390\/jpm12030408&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR34\" id=\"ref-link-section-d41244769e959\" rel=\"nofollow noopener\" target=\"_blank\">34<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#10;                  &#10;                .\" href=\"#ref-CR36\" id=\"ref-link-section-d41244769e962\">36<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#10;                  https:\/\/doi.org\/10.4097\/kja.23064&#10;                  &#10;                .\" href=\"#ref-CR37\" id=\"ref-link-section-d41244769e962_1\">37<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#10;                  https:\/\/doi.org\/10.4097\/kja.22669&#10;                  &#10;                .\" href=\"#ref-CR38\" id=\"ref-link-section-d41244769e962_2\">38<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#10;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#10;                  &#10;                .\" href=\"#ref-CR39\" id=\"ref-link-section-d41244769e962_3\">39<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Iglesias SL, Nieto I, L\u00f3pez P, Almada A, Pioli I, Astore F, et al. Pericapsular nerves block (peng) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: a randomized clinical trial. Rev Esp Cir Ortop Traumatol. 2023;67(3):226\u201332. &#10;                  https:\/\/doi.org\/10.1016\/j.recot.2022.12.004&#10;                  &#10;                .\" href=\"#ref-CR40\" id=\"ref-link-section-d41244769e962_4\">40<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 41\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#010;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR41\" id=\"ref-link-section-d41244769e965\" rel=\"nofollow noopener\" target=\"_blank\">41<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 43\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#010;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR43\" id=\"ref-link-section-d41244769e968\" rel=\"nofollow noopener\" target=\"_blank\">43<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e972\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>] reported a mean age of over 60 years. All nerve blocks were performed under ultrasound guidance. Of the 18 studies, nerve blocks were performed preoperatively in 12 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e975\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Kumar K, Pandey RK, Bhalla AP, Kashyap L, Garg R, Darlong V, et al. Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia Iliaca compartment block for postoperative analgesia in total hip arthroplasty. A prospective randomized study. Acta Anaesthesiol Belg. 2015;66(3):95\u2013100.\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR13\" id=\"ref-link-section-d41244769e978\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#10;                  &#10;                .\" href=\"#ref-CR33\" id=\"ref-link-section-d41244769e981\">33<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#10;                  https:\/\/doi.org\/10.3390\/jpm12030408&#10;                  &#10;                .\" href=\"#ref-CR34\" id=\"ref-link-section-d41244769e981_1\">34<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 35\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#010;                  https:\/\/doi.org\/10.2147\/lra.S350033&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR35\" id=\"ref-link-section-d41244769e984\" rel=\"nofollow noopener\" target=\"_blank\">35<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#10;                  https:\/\/doi.org\/10.4097\/kja.23064&#10;                  &#10;                .\" href=\"#ref-CR37\" id=\"ref-link-section-d41244769e987\">37<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#10;                  https:\/\/doi.org\/10.4097\/kja.22669&#10;                  &#10;                .\" href=\"#ref-CR38\" id=\"ref-link-section-d41244769e987_1\">38<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#10;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#10;                  &#10;                .\" href=\"#ref-CR39\" id=\"ref-link-section-d41244769e987_2\">39<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Iglesias SL, Nieto I, L\u00f3pez P, Almada A, Pioli I, Astore F, et al. Pericapsular nerves block (peng) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: a randomized clinical trial. Rev Esp Cir Ortop Traumatol. 2023;67(3):226\u201332. &#10;                  https:\/\/doi.org\/10.1016\/j.recot.2022.12.004&#10;                  &#10;                .\" href=\"#ref-CR40\" id=\"ref-link-section-d41244769e987_3\">40<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#10;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#10;                  &#10;                .\" href=\"#ref-CR41\" id=\"ref-link-section-d41244769e987_4\">41<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#10;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#10;                  &#10;                .\" href=\"#ref-CR42\" id=\"ref-link-section-d41244769e987_5\">42<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 43\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#010;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR43\" id=\"ref-link-section-d41244769e991\" rel=\"nofollow noopener\" target=\"_blank\">43<\/a>], postoperatively in 5 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#10;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#10;                  &#10;                .\" href=\"#ref-CR30\" id=\"ref-link-section-d41244769e994\">30<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#10;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#10;                  &#10;                .\" href=\"#ref-CR31\" id=\"ref-link-section-d41244769e994_1\">31<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR32\" id=\"ref-link-section-d41244769e997\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 44\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#010;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR44\" id=\"ref-link-section-d41244769e1000\" rel=\"nofollow noopener\" target=\"_blank\">44<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e1003\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>], while 1 study [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 36\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR36\" id=\"ref-link-section-d41244769e1006\" rel=\"nofollow noopener\" target=\"_blank\">36<\/a>] did not specify the timing of the block. Regarding the type of anesthesia used, 6 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e1010\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 30\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#010;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR30\" id=\"ref-link-section-d41244769e1013\" rel=\"nofollow noopener\" target=\"_blank\">30<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 34\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#010;                  https:\/\/doi.org\/10.3390\/jpm12030408&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR34\" id=\"ref-link-section-d41244769e1016\" rel=\"nofollow noopener\" target=\"_blank\">34<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 39\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#010;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR39\" id=\"ref-link-section-d41244769e1019\" rel=\"nofollow noopener\" target=\"_blank\">39<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 41\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#010;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR41\" id=\"ref-link-section-d41244769e1022\" rel=\"nofollow noopener\" target=\"_blank\">41<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 42\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#010;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR42\" id=\"ref-link-section-d41244769e1025\" rel=\"nofollow noopener\" target=\"_blank\">42<\/a>] employed general anesthesia, 10 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Kumar K, Pandey RK, Bhalla AP, Kashyap L, Garg R, Darlong V, et al. Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia Iliaca compartment block for postoperative analgesia in total hip arthroplasty. A prospective randomized study. Acta Anaesthesiol Belg. 2015;66(3):95\u2013100.\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR13\" id=\"ref-link-section-d41244769e1029\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#010;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR31\" id=\"ref-link-section-d41244769e1032\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR32\" id=\"ref-link-section-d41244769e1035\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 35\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#010;                  https:\/\/doi.org\/10.2147\/lra.S350033&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR35\" id=\"ref-link-section-d41244769e1038\" rel=\"nofollow noopener\" target=\"_blank\">35<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#010;                  https:\/\/doi.org\/10.4097\/kja.23064&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR37\" id=\"ref-link-section-d41244769e1041\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 38\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#010;                  https:\/\/doi.org\/10.4097\/kja.22669&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR38\" id=\"ref-link-section-d41244769e1044\" rel=\"nofollow noopener\" target=\"_blank\">38<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 40\" title=\"Iglesias SL, Nieto I, L\u00f3pez P, Almada A, Pioli I, Astore F, et al. Pericapsular nerves block (peng) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: a randomized clinical trial. Rev Esp Cir Ortop Traumatol. 2023;67(3):226\u201332. &#010;                  https:\/\/doi.org\/10.1016\/j.recot.2022.12.004&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR40\" id=\"ref-link-section-d41244769e1048\" rel=\"nofollow noopener\" target=\"_blank\">40<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#10;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#10;                  &#10;                .\" href=\"#ref-CR43\" id=\"ref-link-section-d41244769e1051\">43<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#10;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#10;                  &#10;                .\" href=\"#ref-CR44\" id=\"ref-link-section-d41244769e1051_1\">44<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e1054\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>] used neuraxial anesthesia, and 2 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR33\" id=\"ref-link-section-d41244769e1057\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 36\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR36\" id=\"ref-link-section-d41244769e1060\" rel=\"nofollow noopener\" target=\"_blank\">36<\/a>] included both general anesthesia and neuraxial anesthesia. Regarding the surgical approach in THA, 8 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e1063\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#010;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR31\" id=\"ref-link-section-d41244769e1067\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR32\" id=\"ref-link-section-d41244769e1070\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 34\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#010;                  https:\/\/doi.org\/10.3390\/jpm12030408&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR34\" id=\"ref-link-section-d41244769e1073\" rel=\"nofollow noopener\" target=\"_blank\">34<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#010;                  https:\/\/doi.org\/10.4097\/kja.23064&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR37\" id=\"ref-link-section-d41244769e1076\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 38\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#010;                  https:\/\/doi.org\/10.4097\/kja.22669&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR38\" id=\"ref-link-section-d41244769e1079\" rel=\"nofollow noopener\" target=\"_blank\">38<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 40\" title=\"Iglesias SL, Nieto I, L\u00f3pez P, Almada A, Pioli I, Astore F, et al. Pericapsular nerves block (peng) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: a randomized clinical trial. Rev Esp Cir Ortop Traumatol. 2023;67(3):226\u201332. &#010;                  https:\/\/doi.org\/10.1016\/j.recot.2022.12.004&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR40\" id=\"ref-link-section-d41244769e1082\" rel=\"nofollow noopener\" target=\"_blank\">40<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 43\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#010;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR43\" id=\"ref-link-section-d41244769e1086\" rel=\"nofollow noopener\" target=\"_blank\">43<\/a>] used the posterior approach, 1 study [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 39\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#010;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR39\" id=\"ref-link-section-d41244769e1089\" rel=\"nofollow noopener\" target=\"_blank\">39<\/a>] used the anterior approach, 2 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR33\" id=\"ref-link-section-d41244769e1092\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 41\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#010;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR41\" id=\"ref-link-section-d41244769e1095\" rel=\"nofollow noopener\" target=\"_blank\">41<\/a>] employed the direct lateral approach, while 7 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Kumar K, Pandey RK, Bhalla AP, Kashyap L, Garg R, Darlong V, et al. Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia Iliaca compartment block for postoperative analgesia in total hip arthroplasty. A prospective randomized study. Acta Anaesthesiol Belg. 2015;66(3):95\u2013100.\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR13\" id=\"ref-link-section-d41244769e1098\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 30\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#010;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR30\" id=\"ref-link-section-d41244769e1101\" rel=\"nofollow noopener\" target=\"_blank\">30<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 35\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#010;                  https:\/\/doi.org\/10.2147\/lra.S350033&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR35\" id=\"ref-link-section-d41244769e1105\" rel=\"nofollow noopener\" target=\"_blank\">35<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 36\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR36\" id=\"ref-link-section-d41244769e1108\" rel=\"nofollow noopener\" target=\"_blank\">36<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 42\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#010;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR42\" id=\"ref-link-section-d41244769e1111\" rel=\"nofollow noopener\" target=\"_blank\">42<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 44\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#010;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR44\" id=\"ref-link-section-d41244769e1114\" rel=\"nofollow noopener\" target=\"_blank\">44<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e1117\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>] did not specify the surgical approach. Detailed baseline characteristics of studies can be found in Table <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab1\" rel=\"nofollow noopener\" target=\"_blank\">1<\/a>.<\/p>\n<p><b id=\"Tab1\" data-test=\"table-caption\">Table 1 Baseline characteristics<\/b>Methodological quality assessment of included studies<\/p>\n<p>The risk of bias assessment results of the 18 studies are shown in Fig. <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig2\" rel=\"nofollow noopener\" target=\"_blank\">2<\/a>. Several methodological concerns were identified in randomization-related bias: two studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 39\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#010;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR39\" id=\"ref-link-section-d41244769e3857\" rel=\"nofollow noopener\" target=\"_blank\">39<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 44\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#010;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR44\" id=\"ref-link-section-d41244769e3860\" rel=\"nofollow noopener\" target=\"_blank\">44<\/a>] were deemed to have a high risk of bias as the allocation was not adequately concealed, and a third study [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 41\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#010;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR41\" id=\"ref-link-section-d41244769e3863\" rel=\"nofollow noopener\" target=\"_blank\">41<\/a>] showed significant differences in baseline characteristics between the exposed and control groups. Two further studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 30\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#010;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR30\" id=\"ref-link-section-d41244769e3866\" rel=\"nofollow noopener\" target=\"_blank\">30<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e3870\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>] had raised moderate concerns related to either insufficient randomization, or inadequate allocation concealment protocols. The remaining thirteen studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e3873\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Kumar K, Pandey RK, Bhalla AP, Kashyap L, Garg R, Darlong V, et al. Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia Iliaca compartment block for postoperative analgesia in total hip arthroplasty. A prospective randomized study. Acta Anaesthesiol Belg. 2015;66(3):95\u2013100.\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR13\" id=\"ref-link-section-d41244769e3876\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#10;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#10;                  &#10;                .\" href=\"#ref-CR31\" id=\"ref-link-section-d41244769e3879\">31<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#10;                  &#10;                .\" href=\"#ref-CR32\" id=\"ref-link-section-d41244769e3879_1\">32<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#10;                  &#10;                .\" href=\"#ref-CR33\" id=\"ref-link-section-d41244769e3879_2\">33<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#10;                  https:\/\/doi.org\/10.3390\/jpm12030408&#10;                  &#10;                .\" href=\"#ref-CR34\" id=\"ref-link-section-d41244769e3879_3\">34<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#10;                  https:\/\/doi.org\/10.2147\/lra.S350033&#10;                  &#10;                .\" href=\"#ref-CR35\" id=\"ref-link-section-d41244769e3879_4\">35<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#10;                  &#10;                .\" href=\"#ref-CR36\" id=\"ref-link-section-d41244769e3879_5\">36<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#10;                  https:\/\/doi.org\/10.4097\/kja.23064&#10;                  &#10;                .\" href=\"#ref-CR37\" id=\"ref-link-section-d41244769e3879_6\">37<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 38\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#010;                  https:\/\/doi.org\/10.4097\/kja.22669&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR38\" id=\"ref-link-section-d41244769e3882\" rel=\"nofollow noopener\" target=\"_blank\">38<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 40\" title=\"Iglesias SL, Nieto I, L\u00f3pez P, Almada A, Pioli I, Astore F, et al. Pericapsular nerves block (peng) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: a randomized clinical trial. Rev Esp Cir Ortop Traumatol. 2023;67(3):226\u201332. &#010;                  https:\/\/doi.org\/10.1016\/j.recot.2022.12.004&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR40\" id=\"ref-link-section-d41244769e3885\" rel=\"nofollow noopener\" target=\"_blank\">40<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 42\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#010;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR42\" id=\"ref-link-section-d41244769e3889\" rel=\"nofollow noopener\" target=\"_blank\">42<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 43\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#010;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR43\" id=\"ref-link-section-d41244769e3892\" rel=\"nofollow noopener\" target=\"_blank\">43<\/a>] had robust randomization procedures and were classified as low risk. With respect to missing outcome data and outcome measurement, all studies were judged to be at low risk of bias as there were no significant departures from their planned interventions. All studies were assessed as having an unclear risk in selective reporting because none of them clarified whether the analysis methods before and after unblinding were consistent. In general, these studies were found to be at unclear risk of bias. More details are provided in Supplementary Material, Table S5.<\/p>\n<p><b id=\"Fig2\" class=\"c-article-section__figure-caption\" data-test=\"figure-caption-text\">Fig. 2<\/b><a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2\/figures\/2\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig2\" src=\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/10\/12871_2025_3395_Fig2_HTML.png\" alt=\"figure 2\" loading=\"lazy\" width=\"685\" height=\"1020\"\/><\/a>The certainty of evidence<\/p>\n<p>The results of the CINeMA framework for assessing the quality of evidence showed that the confidence level of the evidence for dynamic pain scores 24\u00a0h after surgery was mainly very low. The confidence level of the evidence for static pain scores 24\u00a0h after surgery was mainly low. The confidence level of the evidence for OME 24\u00a0h after surgery was mainly very low. The confidence level of the evidence for postoperative nausea or vomiting was mainly low (Table\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab2\" rel=\"nofollow noopener\" target=\"_blank\">2.<\/a>).<\/p>\n<p><b id=\"Tab2\" data-test=\"table-caption\">Table 2 Certainty of the evidence<\/b>Network analysis resultsNetwork diagram<\/p>\n<p>Eleven distinct nerve block interventions were covered in the 18 included studies: circum-psoas block (CPB), FNB, I_FICB, lumbar erector spinae plane block at the L3 vertebra level (L3_ESPB), lumbar erector spinae plane block at the L4 vertebra level (L4_ESPB), LPB, PENG, lateral quadratus lumborum block (QLB1), anterior quadratus lumborum block (QLB3), S_FICB, and paravertebral nerve block at the T12 vertebra level (T12_PVB). Figure\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig3\" rel=\"nofollow noopener\" target=\"_blank\">3<\/a> illustrates the relationships between interventions. The line thickness is proportional to the number of comparative studies, and the node size is proportional to the sample size for each intervention. Node-splitting analysis was conducted for outcomes with closed loops (Fig.\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>). The P values for the 24-hour postoperative static pain score, 24-hour postoperative OME, and postoperative vomiting were greater than 0.05, suggesting no local inconsistency. Due to the absence of closed loops in both the 24-hour postoperative dynamic pain scores and postoperative nausea data, node-splitting analysis was not conducted.<\/p>\n<p><b id=\"Fig3\" class=\"c-article-section__figure-caption\" data-test=\"figure-caption-text\">Fig. 3<\/b><a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2\/figures\/3\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig3\" src=\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/10\/12871_2025_3395_Fig3_HTML.png\" alt=\"figure 3\" loading=\"lazy\" width=\"685\" height=\"406\"\/><\/a><\/p>\n<p>Network diagram. <b>A<\/b>\u00a024-hour dynamic pain score after surgery; <b>B<\/b>\u00a024-hour static pain score after surgery; <b>C<\/b> 24-hour OME after surgery; <b>D<\/b>\u00a0Postoperative nausea; <b>E<\/b>\u00a0Postoperative vomiting<\/p>\n<p><b id=\"Fig4\" class=\"c-article-section__figure-caption\" data-test=\"figure-caption-text\">Fig. 4<\/b><a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2\/figures\/4\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig4\" src=\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/10\/12871_2025_3395_Fig4_HTML.png\" alt=\"figure 4\" loading=\"lazy\" width=\"685\" height=\"1565\"\/><\/a><\/p>\n<p>Node splitting analysis. <b>A<\/b>\u00a024-hour static pain score after surgery; <b>B<\/b>\u00a024-hour OME after surgery; <b>C<\/b>\u00a0Postoperative vomiting<\/p>\n<p>24-hour postoperative dynamic pain score<\/p>\n<p>A total of 9 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#10;                  &#10;                .\" href=\"#ref-CR32\" id=\"ref-link-section-d41244769e14381\">32<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#10;                  &#10;                .\" href=\"#ref-CR33\" id=\"ref-link-section-d41244769e14381_1\">33<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 34\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#010;                  https:\/\/doi.org\/10.3390\/jpm12030408&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR34\" id=\"ref-link-section-d41244769e14384\" rel=\"nofollow noopener\" target=\"_blank\">34<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#010;                  https:\/\/doi.org\/10.4097\/kja.23064&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR37\" id=\"ref-link-section-d41244769e14387\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#10;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#10;                  &#10;                .\" href=\"#ref-CR41\" id=\"ref-link-section-d41244769e14390\">41<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#10;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#10;                  &#10;                .\" href=\"#ref-CR42\" id=\"ref-link-section-d41244769e14390_1\">42<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 43\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#010;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR43\" id=\"ref-link-section-d41244769e14393\" rel=\"nofollow noopener\" target=\"_blank\">43<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e14397\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>], including 542 subjects, reported this outcome. The interventions included CPB, FNB, I_FICB, L3_ESPB, LPB, PENG, QLB3, and S_FICB. The results demonstrated that compared with S_FICB, CPB (MD = \u22120.57, 95% CrI: \u22120.89, \u22120.25), FNB (MD = \u22122.5, 95% CrI: \u22123.6, \u22121.41), I_FICB (MD = \u22122.94, 95% CrI: \u22124.72, \u22121.16), L3_ESPB (MD = \u22122.66, 95% CrI: \u22124.79, \u22120.52), PENG (MD = \u22121.84, 95% CrI: \u22122.08, \u22121.61), and QLB3 (MD = \u22122.04, 95% CrI: \u22122.64, \u22121.45) were associated with lower 24-hour postoperative dynamic pain scores. Compared with CPB, FNB (MD = \u22121.93, 95% CrI: \u22123.07, \u22120.79), I_FICB (MD = \u22122.37, 95% CrI: \u22124.18, \u22120.57), PENG (MD = \u22121.27, 95% CrI: \u22121.67, \u22120.88), and QLB3 (MD = \u22121.47, 95% CrI: \u22122.14, \u22120.80) were also associated with lower 24-hour postoperative dynamic pain scores (Table <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab2\" rel=\"nofollow noopener\" target=\"_blank\">2.<\/a>.). Based on the cumulative probability analysis, I_FICB (SUCRA: 85.71%) ranked highest in reducing 24-hour postoperative dynamic pain scores, followed by FNB (SUCRA: 77.00%), while S_FICB (SUCRA: 0.51%) ranked last. (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab3\" rel=\"nofollow noopener\" target=\"_blank\">3.<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>; Figs. <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a>). Subgroup analysis based on anesthesia method showed that in the spinal anesthesia group, CPB ranked highest for 24-hour dynamic pain scores. However, the general anesthesia group was not eligible for further analysis due to no closed loop. Subgroup analysis based on surgical approach showed that the postoperative group was not eligible for further analysis due to no closed loop, and the preoperative group was not eligible for further analysis due to DIC values greater than 5. (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a>, <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab7\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>)<\/p>\n<p><b id=\"Tab4\" data-test=\"table-caption\">Table 4 Cumulative probability ranking table<\/b><b id=\"Fig5\" class=\"c-article-section__figure-caption\" data-test=\"figure-caption-text\">Fig. 5<\/b><a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2\/figures\/5\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig5\" src=\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/10\/12871_2025_3395_Fig5_HTML.png\" alt=\"figure 5\" loading=\"lazy\" width=\"685\" height=\"363\"\/><\/a><\/p>\n<p>surface under the cumulative ranking curve line chart. <b>A<\/b>\u00a024-hour dynamic pain score after surgery; <b>B<\/b>\u00a024-hour static pain score after surgery; <b>C<\/b>\u00a024-hour OME after surgery; <b>D<\/b>\u00a0Postoperative nausea; <b>E<\/b>) Postoperative vomiting<\/p>\n<p><b id=\"Fig6\" class=\"c-article-section__figure-caption\" data-test=\"figure-caption-text\">Fig. 6<\/b><a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2\/figures\/6\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig6\" src=\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/10\/12871_2025_3395_Fig6_HTML.png\" alt=\"figure 6\" loading=\"lazy\" width=\"685\" height=\"304\"\/><\/a>24-hour postoperative static pain score<\/p>\n<p>A total of 10 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#10;                  &#10;                .\" href=\"#ref-CR32\" id=\"ref-link-section-d41244769e14968\">32<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#10;                  &#10;                .\" href=\"#ref-CR33\" id=\"ref-link-section-d41244769e14968_1\">33<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#10;                  https:\/\/doi.org\/10.3390\/jpm12030408&#10;                  &#10;                .\" href=\"#ref-CR34\" id=\"ref-link-section-d41244769e14968_2\">34<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 35\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#010;                  https:\/\/doi.org\/10.2147\/lra.S350033&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR35\" id=\"ref-link-section-d41244769e14971\" rel=\"nofollow noopener\" target=\"_blank\">35<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#010;                  https:\/\/doi.org\/10.4097\/kja.23064&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR37\" id=\"ref-link-section-d41244769e14974\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 40\" title=\"Iglesias SL, Nieto I, L\u00f3pez P, Almada A, Pioli I, Astore F, et al. Pericapsular nerves block (peng) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: a randomized clinical trial. Rev Esp Cir Ortop Traumatol. 2023;67(3):226\u201332. &#010;                  https:\/\/doi.org\/10.1016\/j.recot.2022.12.004&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR40\" id=\"ref-link-section-d41244769e14977\" rel=\"nofollow noopener\" target=\"_blank\">40<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 41\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#010;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR41\" id=\"ref-link-section-d41244769e14980\" rel=\"nofollow noopener\" target=\"_blank\">41<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#10;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#10;                  &#10;                .\" href=\"#ref-CR43\" id=\"ref-link-section-d41244769e14984\">43<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#10;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#10;                  &#10;                .\" href=\"#ref-CR44\" id=\"ref-link-section-d41244769e14984_1\">44<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e14987\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>], including 576 subjects, reported this outcome. The interventions included CPB, FNB, I_FICB, L3_ESPB, L4_ESPB, LPB, PENG, QLB3, and S_FICB. The results revealed that, compared with L4_ESPB, CPB (MD = \u22120.71, 95% CrI: \u22121.4, \u22120.02), I_FICB (MD = \u22121.88, 95% CrI: \u22123.56, \u22120.2), and LPB (MD = \u22121.25, 95% CrI: \u22122.28, \u22120.22) were associated with lower 24-hour postoperative static pain scores. Compared with PENG, LPB (MD = \u22120.66, 95% CrI: \u22121.12, \u22120.19) was associated with lower 24-hour postoperative static pain scores (Table <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab2\" rel=\"nofollow noopener\" target=\"_blank\">2.<\/a>.). Based on the cumulative probability analysis, I_FICB (SUCRA: 88.90%) ranked first in reducing 24-hour postoperative static pain scores, followed by LPB (SUCRA: 72.46%), while L4_ESPB (SUCRA: 4.37%) ranked last (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab3\" rel=\"nofollow noopener\" target=\"_blank\">3.<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>; Figs. <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a>). Subgroup analysis by anesthesia method showed that I_FICB ranked highest for 24-hour static pain scores in the spinal anesthesia group, while further analysis was not possible in the general anesthesia group due to no closed loop. Subgroup analysis by surgical approach showed that CPB ranked highest in the preoperative group, while further analysis was not possible in the postoperative group due to no closed loop (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a>, <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab7\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>).<\/p>\n<p><b id=\"Tab5\" data-test=\"table-caption\">Table 5 Details of subgroup<\/b><b id=\"Tab6\" data-test=\"table-caption\">Table 6 SUCRA of subgroup<\/b><b id=\"Tab7\" data-test=\"table-caption\">Table 7 Global inconsistency tests of subgroup<\/b>24-hour postoperative OME<\/p>\n<p>A total of 12 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Kumar K, Pandey RK, Bhalla AP, Kashyap L, Garg R, Darlong V, et al. Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia Iliaca compartment block for postoperative analgesia in total hip arthroplasty. A prospective randomized study. Acta Anaesthesiol Belg. 2015;66(3):95\u2013100.\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR13\" id=\"ref-link-section-d41244769e20731\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 30\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#010;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR30\" id=\"ref-link-section-d41244769e20734\" rel=\"nofollow noopener\" target=\"_blank\">30<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#10;                  &#10;                .\" href=\"#ref-CR32\" id=\"ref-link-section-d41244769e20737\">32<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Gutierrez JJP, Ben-David B, Rest C, Grajales MT, Khetarpal SK. Quadratus lumborum block type 3 versus lumbar plexus block in hip replacement surgery: a randomized, prospective, non-inferiority study. Reg Anesth Pain Med. 2021;46(2):111\u20137. &#10;                  https:\/\/doi.org\/10.1136\/rapm-2020-101915&#10;                  &#10;                .\" href=\"#ref-CR33\" id=\"ref-link-section-d41244769e20737_1\">33<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#10;                  https:\/\/doi.org\/10.3390\/jpm12030408&#10;                  &#10;                .\" href=\"#ref-CR34\" id=\"ref-link-section-d41244769e20737_2\">34<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#10;                  https:\/\/doi.org\/10.2147\/lra.S350033&#10;                  &#10;                .\" href=\"#ref-CR35\" id=\"ref-link-section-d41244769e20737_3\">35<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 36\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR36\" id=\"ref-link-section-d41244769e20740\" rel=\"nofollow noopener\" target=\"_blank\">36<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 38\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#010;                  https:\/\/doi.org\/10.4097\/kja.22669&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR38\" id=\"ref-link-section-d41244769e20743\" rel=\"nofollow noopener\" target=\"_blank\">38<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#10;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#10;                  &#10;                .\" href=\"#ref-CR41\" id=\"ref-link-section-d41244769e20747\">41<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#10;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#10;                  &#10;                .\" href=\"#ref-CR42\" id=\"ref-link-section-d41244769e20747_1\">42<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#10;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#10;                  &#10;                .\" href=\"#ref-CR43\" id=\"ref-link-section-d41244769e20747_2\">43<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 44\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#010;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR44\" id=\"ref-link-section-d41244769e20750\" rel=\"nofollow noopener\" target=\"_blank\">44<\/a>], including 710 subjects, reported this outcome. The interventions included CPB, FNB, I_FICB, L4_ESPB, LPB, PENG, QLB1, QLB3, and S_FICB. The results suggested that, compared with CPB, I_FICB (MD = 14.56, 95% CrI: 9.42, 19.65), L4_ESPB (MD = 9.68, 95% CrI: 4.43, 14.91), PENG (MD = 6.22, 95% CrI: 0.37, 12.04), and S_FICB (MD = 11.41, 95% CrI: 6.73, 16.04) were associated with higher 24-hour postoperative opioid consumption. Compared with I_FICB, L4_ESPB (MD = \u22124.88, 95% CrI: \u22128.05, \u22121.7), PENG (MD = \u22128.34, 95% CrI: \u221212.44, \u22124.23), and S_FICB (MD = \u22123.15, 95% CrI: \u22125.25, \u22121.07) were associated with lower 24-hour postoperative opioid consumption. Additionally, PENG (MD = \u22125.2, 95% CrI: \u22128.73, \u22121.65) was associated with a significantly lower 24-hour postoperative opioid consumption than S_FICB (Table <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab3\" rel=\"nofollow noopener\" target=\"_blank\">3.<\/a>). Based on the cumulative probability analysis, LPB (SUCRA: 78.10%) ranked first in reducing the 24-hour postoperative opioid consumption, followed by CPB (SUCRA: 77.96%), while I_FICB (SUCRA: 14.66%) ranked last (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab8\" rel=\"nofollow noopener\" target=\"_blank\">8.<\/a>; Figs. <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a>). Subgroup analysis based on anesthesia method showed that in the spinal anesthesia group, DIC values were greater than 5, and in the general anesthesia group, network nodes were not connected. Hence, further analysis was not performed. Subgroup analysis based on surgical approach showed that CPB ranked highest in the preoperative group. Furthermore, analysis was not performed in the postoperative group due to no closed loop. (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a>, <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab7\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>)<\/p>\n<p><b id=\"Tab8\" data-test=\"table-caption\">Table 8 League table (24-hour OME after surgery)<\/b>Postoperative nausea<\/p>\n<p>A total of 12 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e20811\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Kumar K, Pandey RK, Bhalla AP, Kashyap L, Garg R, Darlong V, et al. Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia Iliaca compartment block for postoperative analgesia in total hip arthroplasty. A prospective randomized study. Acta Anaesthesiol Belg. 2015;66(3):95\u2013100.\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR13\" id=\"ref-link-section-d41244769e20814\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#10;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#10;                  &#10;                .\" href=\"#ref-CR30\" id=\"ref-link-section-d41244769e20817\">30<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#10;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#10;                  &#10;                .\" href=\"#ref-CR31\" id=\"ref-link-section-d41244769e20817_1\">31<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR32\" id=\"ref-link-section-d41244769e20820\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 34\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#010;                  https:\/\/doi.org\/10.3390\/jpm12030408&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR34\" id=\"ref-link-section-d41244769e20823\" rel=\"nofollow noopener\" target=\"_blank\">34<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#10;                  https:\/\/doi.org\/10.4097\/kja.23064&#10;                  &#10;                .\" href=\"#ref-CR37\" id=\"ref-link-section-d41244769e20827\">37<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#10;                  https:\/\/doi.org\/10.4097\/kja.22669&#10;                  &#10;                .\" href=\"#ref-CR38\" id=\"ref-link-section-d41244769e20827_1\">38<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 39\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#010;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR39\" id=\"ref-link-section-d41244769e20830\" rel=\"nofollow noopener\" target=\"_blank\">39<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#10;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#10;                  &#10;                .\" href=\"#ref-CR43\" id=\"ref-link-section-d41244769e20833\">43<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#10;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#10;                  &#10;                .\" href=\"#ref-CR44\" id=\"ref-link-section-d41244769e20833_1\">44<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e20836\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>], including 777 subjects, reported this outcome. The interventions included CPB, FNB, I_FICB, L3_ESPB, L4_ESPB, LPB, PENG, QLB3, S_FICB, and T12_PVB. The results indicated that, compared with I_FICB, CPB (RR = 0.09, 95% CrI: 0.01, 0.91), L4_ESPB (RR = 0.09, 95% CrI: 0.01, 0.59), and S_FICB (RR = 0.16, 95% CrI: 0.02, 0.54) were associated with a lower incidence of postoperative nausea (Table <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>). Based on the cumulative probability analysis, L4_ESPB (SUCRA: 81.22%) ranked first in reducing postoperative nausea, followed by CPB (SUCRA: 75.87%), while I_FICB (SUCRA: 8.41%) ranked last (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab9\" rel=\"nofollow noopener\" target=\"_blank\">9.<\/a>; Figs. <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a>). Subgroup analysis based on anesthesia method showed that L4_ESPB ranked first in the spinal anesthesia group. Network nodes in the general anesthesia group were disconnected, and further analysis was not performed. Subgroup analysis based on surgical approach showed that L4_ESPB ranked first in the preoperative group. Further analysis was not possible in the postoperative group since network nodes were disconnected (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a>, <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab7\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>).<\/p>\n<p><b id=\"Tab9\" data-test=\"table-caption\">Table 9 League table (Postoperative nausea\/vomiting)<\/b>Postoperative vomiting<\/p>\n<p>A total of 12 studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e20899\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Kumar K, Pandey RK, Bhalla AP, Kashyap L, Garg R, Darlong V, et al. Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia Iliaca compartment block for postoperative analgesia in total hip arthroplasty. A prospective randomized study. Acta Anaesthesiol Belg. 2015;66(3):95\u2013100.\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR13\" id=\"ref-link-section-d41244769e20902\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#10;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#10;                  &#10;                .\" href=\"#ref-CR30\" id=\"ref-link-section-d41244769e20905\">30<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#10;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#10;                  &#10;                .\" href=\"#ref-CR31\" id=\"ref-link-section-d41244769e20905_1\">31<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR32\" id=\"ref-link-section-d41244769e20908\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#010;                  https:\/\/doi.org\/10.4097\/kja.23064&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR37\" id=\"ref-link-section-d41244769e20911\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 38\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#010;                  https:\/\/doi.org\/10.4097\/kja.22669&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR38\" id=\"ref-link-section-d41244769e20915\" rel=\"nofollow noopener\" target=\"_blank\">38<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#10;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#10;                  &#10;                .\" href=\"#ref-CR41\" id=\"ref-link-section-d41244769e20918\">41<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#10;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#10;                  &#10;                .\" href=\"#ref-CR42\" id=\"ref-link-section-d41244769e20918_1\">42<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#10;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#10;                  &#10;                .\" href=\"#ref-CR43\" id=\"ref-link-section-d41244769e20918_2\">43<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#10;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#10;                  &#10;                .\" href=\"#ref-CR44\" id=\"ref-link-section-d41244769e20918_3\">44<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 45\" title=\"Kaciroglu A, Ekinci M, Dikici M, Aydemir O, Demiroluk O, Erdogan D, et al. Lumbar erector spinae plane block versus infrainguinal fascia Iliaca compartment block for pain management after total hip arthroplasty: A randomized clinical trial. Pain Med. 2019;25(4):257\u201362. &#010;                  https:\/\/doi.org\/10.1093\/pm\/pnad166&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR45\" id=\"ref-link-section-d41244769e20921\" rel=\"nofollow noopener\" target=\"_blank\">45<\/a>], including 735 subjects, reported this outcome. The interventions included CPB, FNB, I_FICB, L3_ESPB, L4_ESPB, LPB, PENG, QLB3, and S_FICB. Compared with I_FICB, L4_ESPB (RR = 0.08, 95% CrI: 0, 0.94) and S_FICB (RR = 0.15, 95% CrI: 0.01, 0.98) were associated with a lower incidence of postoperative vomiting (Table <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>). Based on the cumulative probability analysis, L4_ESPB (SUCRA: 76.09%) ranked first in reducing postoperative vomiting, followed by QLB3 (SUCRA: 70.06%), while I_FICB (SUCRA: 11.76%) ranked last (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab9\" rel=\"nofollow noopener\" target=\"_blank\">9.<\/a>; Figs. <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a>). Subgroup analysis based on anesthesia method showed that network nodes in the spinal anesthesia group were not connected, and further analysis was not performed. L4_ESPB ranked first in the general anesthesia group. Subgroup analysis based on surgical approach showed that L4_ESPB ranked first in both the preoperative and postoperative groups (Tables <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a>, <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab6\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Tab7\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>).<\/p>\n<p>Summary of other adverse events<\/p>\n<p>Due to the low incidence of other adverse events or the limited number of included studies, a network meta-analysis could not be performed. Thus, only a descriptive analysis is provided. Eight studies evaluated 24-hour postoperative quadriceps muscle strength. Among these studies, six studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e20958\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#010;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR31\" id=\"ref-link-section-d41244769e20961\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR32\" id=\"ref-link-section-d41244769e20964\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 35\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#010;                  https:\/\/doi.org\/10.2147\/lra.S350033&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR35\" id=\"ref-link-section-d41244769e20967\" rel=\"nofollow noopener\" target=\"_blank\">35<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#010;                  https:\/\/doi.org\/10.4097\/kja.23064&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR37\" id=\"ref-link-section-d41244769e20970\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 41\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#010;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR41\" id=\"ref-link-section-d41244769e20974\" rel=\"nofollow noopener\" target=\"_blank\">41<\/a>] reported no statistically significant differences in the distribution of quadriceps muscle strength rates (such as no block, paresis, and paralysis). Specifically, Bravo et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#010;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR31\" id=\"ref-link-section-d41244769e20977\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>] reported that the incidence of paralysis was 3.33% and 0% in the LPB group and S_FICB group, respectively. Aliste et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR32\" id=\"ref-link-section-d41244769e20980\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>] observed the incidence of paralysis was 0% and 10% in the PENG group and S_FICB group, respectively. Takeda et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 41\" title=\"Takeda Y, Tsujimoto K, Okamoto T, Nakai T, Fukunishi S, Tachibana T. Efficacy of anterior quadratus lumborum block and pain after total hip arthroplasty: a randomized controlled trial. J Arthroplasty. 2023;38(11):2386\u201392. &#010;                  https:\/\/doi.org\/10.1016\/j.arth.2023.05.044&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR41\" id=\"ref-link-section-d41244769e20983\" rel=\"nofollow noopener\" target=\"_blank\">41<\/a>] found that the incidence of paralysis was higher in the QLB3 and FNB groups, at 44.44% and 39.29%, respectively. The remaining three studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e20986\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 35\" title=\"Hashmi J, Cusack B, Hughes L, Singh V, Srinivasan K. Transmuscular quadratus lumborum block versus infrainguinal fascia iliaca nerve block for patients undergoing elective hip replacement: a double-blinded, pilot, randomized controlled trial. Local Reg Anesth. 2022;15:45\u201355. &#010;                  https:\/\/doi.org\/10.2147\/lra.S350033&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR35\" id=\"ref-link-section-d41244769e20989\" rel=\"nofollow noopener\" target=\"_blank\">35<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#010;                  https:\/\/doi.org\/10.4097\/kja.23064&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR37\" id=\"ref-link-section-d41244769e20993\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>] did not report any cases of paralysis. The other two studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 36\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR36\" id=\"ref-link-section-d41244769e20996\" rel=\"nofollow noopener\" target=\"_blank\">36<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 43\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#010;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR43\" id=\"ref-link-section-d41244769e20999\" rel=\"nofollow noopener\" target=\"_blank\">43<\/a>] also found no statistically significant differences between groups. Some other postoperative adverse events were also reported, none of which showed statistically significant differences between groups. Abdelaziz et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 44\" title=\"Abdelaziz AA, Youssef NE, Hazem AM, Abdelsalam TS, Abdelaziz MM. A comparative study between postoperative analgesia of suprainguinal fascia Iliaca compartment block (sifi) and lumbar erector spinae plane block (espb) in hip arthroplasty. Egypt J Anaesth. 2024;40(1):325\u201333. &#010;                  https:\/\/doi.org\/10.1080\/11101849.2024.2355713&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR44\" id=\"ref-link-section-d41244769e21002\" rel=\"nofollow noopener\" target=\"_blank\">44<\/a>] observed 1 and 3 cases of hypotension, and 1 and 0 cases of bradycardia in the S_FICB and L4_ESPB groups, respectively; Vamshi et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 42\" title=\"Vamshi C, Sinha C, Kumar A, Kumar A, Kumari P, Kumar A, et al. Comparison of the efficacy of pericapsular nerve group block (peng) block versus suprainguinal fascia Iliaca block (sfib) in total hip arthroplasty: a randomized control trial. Indian J Anaesth. 2023;67(4):364\u20139. &#010;                  https:\/\/doi.org\/10.4103\/ija.ija_311_22&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR42\" id=\"ref-link-section-d41244769e21005\" rel=\"nofollow noopener\" target=\"_blank\">42<\/a>] reported one case of respiratory depression in both the PENG and S_FICB groups. Urinary retention was reported in four studies. Zheng et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 43\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#010;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR43\" id=\"ref-link-section-d41244769e21008\" rel=\"nofollow noopener\" target=\"_blank\">43<\/a>] reported 1 case in the CPB group and 2 cases in the S_FICB group. Flaviano et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 38\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#010;                  https:\/\/doi.org\/10.4097\/kja.22669&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR38\" id=\"ref-link-section-d41244769e21012\" rel=\"nofollow noopener\" target=\"_blank\">38<\/a>] reported 5 cases in both the L4_ESPB and S_FICB groups. Et et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Et T, Korkusuz M. Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2023;76(6):575\u201385. &#010;                  https:\/\/doi.org\/10.4097\/kja.23064&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR37\" id=\"ref-link-section-d41244769e21015\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>] observed 1 case in the PENG group and none in the QLB3 group. Choi et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 34\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#010;                  https:\/\/doi.org\/10.3390\/jpm12030408&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR34\" id=\"ref-link-section-d41244769e21018\" rel=\"nofollow noopener\" target=\"_blank\">34<\/a>] noted 2 cases in the PENG group and 1 case in the S_FICB group. One-year postoperative chronic pain was reported in two studies. Flaviano et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 38\" title=\"Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia Iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean J Anesthesiol. 2023;76(4):326\u201335. &#010;                  https:\/\/doi.org\/10.4097\/kja.22669&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR38\" id=\"ref-link-section-d41244769e21021\" rel=\"nofollow noopener\" target=\"_blank\">38<\/a>] reported 6 cases in the L4_ESPB group and 3 cases in the S_FICB group, while Wang et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 12\" title=\"Wang QR, Ma T, Hu J, Yang J, Kang PD. Comparison between ultrasound-guided pericapsular nerve group block and anterio quadratus lumborum block for total hip arthroplasty: a double-blind, randomized controlled trial. Eur Rev Med Pharmacol Sci. 2023;27(16):7523\u201332. &#010;                  https:\/\/doi.org\/10.26355\/eurrev_202308_33404&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR12\" id=\"ref-link-section-d41244769e21024\" rel=\"nofollow noopener\" target=\"_blank\">12<\/a>] reported 1 case in the PENG group and 3 cases in the QLB3 group. Additionally, epidural spread was reported in two studies. Biboulet et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 30\" title=\"Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or Psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004;29(2):102\u20139. &#010;                  https:\/\/doi.org\/10.1016\/j.rapm.2003.11.006&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR30\" id=\"ref-link-section-d41244769e21027\" rel=\"nofollow noopener\" target=\"_blank\">30<\/a>] reported 4 cases in the LPB group and none in the FNB group, though statistical analysis of intergroup differences was not provided. Bravo et al. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Bravo D, Layera S, Aliste J, Jara \u00c1, Fern\u00e1ndez D, Barrientos C, et al. Lumbar plexus block versus suprainguinal fascia Iliaca block for total hip arthroplasty: a single-blinded, randomized trial. J Clin Anesth. 2020. &#010;                  https:\/\/doi.org\/10.1016\/j.jclinane.2020.109907&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR31\" id=\"ref-link-section-d41244769e21031\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>] reported 2 cases in the LPB group and none in the S_FICB group, with no statistically significant difference between groups. One study [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 39\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#010;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR39\" id=\"ref-link-section-d41244769e21034\" rel=\"nofollow noopener\" target=\"_blank\">39<\/a>] additionally reported that a patient in the QLB3 group was readmitted after discharge due to pulmonary embolism. Seven studies reported the duration of hospital stay. One study [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 40\" title=\"Iglesias SL, Nieto I, L\u00f3pez P, Almada A, Pioli I, Astore F, et al. Pericapsular nerves block (peng) is an effective and safe alternative for postoperative pain management after primary total hip arthroplasty: a randomized clinical trial. Rev Esp Cir Ortop Traumatol. 2023;67(3):226\u201332. &#010;                  https:\/\/doi.org\/10.1016\/j.recot.2022.12.004&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR40\" id=\"ref-link-section-d41244769e21037\" rel=\"nofollow noopener\" target=\"_blank\">40<\/a>] reported significantly prolonged hospitalization with LPB compared to PENG (p 31, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"Aliste J, Layera S, Bravo D, Jara A, Mu\u00f1oz G, Barrientos C, et al. Randomized comparison between pericapsular nerve group (peng) block and suprainguinal fascia Iliaca block for total hip arthroplasty. Reg Anesth Pain Med. 2021;46(10):874\u20138. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2021-102997&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR32\" id=\"ref-link-section-d41244769e21046\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 34\" title=\"Choi YS, Park KK, Lee B, Nam WS, Kim DH. Pericapsular nerve group (peng) block versus supra-inguinal fascia Iliaca compartment block for total hip arthroplasty: a randomized clinical trial. J Pers Med. 2022. &#010;                  https:\/\/doi.org\/10.3390\/jpm12030408&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR34\" id=\"ref-link-section-d41244769e21050\" rel=\"nofollow noopener\" target=\"_blank\">34<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 36\" title=\"Kelly T, Wolla CD, Wolf BJ, Hay E, Babb S, Wilson SH. Comparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. 2022;47(9):541\u20136. &#010;                  https:\/\/doi.org\/10.1136\/rapm-2022-103598&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR36\" id=\"ref-link-section-d41244769e21053\" rel=\"nofollow noopener\" target=\"_blank\">36<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 39\" title=\"Hummel A, Gaucher D, Wang P, Lawton DRY, Andrews SN, Nakasone CK. Higher intra-operative narcotic requirements and weakness with quadratus lumborum compared to paravertebral nerve block for total hip arthroplasty. Arch Orthop Trauma Surg. 2023;143(11):6849\u201355. &#010;                  https:\/\/doi.org\/10.1007\/s00402-023-04925-8&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR39\" id=\"ref-link-section-d41244769e21056\" rel=\"nofollow noopener\" target=\"_blank\">39<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 43\" title=\"Zheng JW, Mi Y, Liang JH, Li HL, Shao PQ, Wen H, et al. Circum-psoas block versus supra-inguinal fascia Iliaca block for postoperative analgesia in patients undergoing total hip arthroplasty: a randomized clinical trial. J Pain Res. 2023;16:3961\u201370. &#010;                  https:\/\/doi.org\/10.2147\/jpr.S435159&#010;                  &#010;                .\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#ref-CR43\" id=\"ref-link-section-d41244769e21059\" rel=\"nofollow noopener\" target=\"_blank\">43<\/a>] showed no statistically significant differences between groups.<\/p>\n<p>Convergence diagnostics, sensitivity analysis, publication bias, heterogeneity analysis, and regression analysis<\/p>\n<p>For all outcomes, overall consistency was assessed by comparing the consistency model and the inconsistency model using the DIC. The results indicated favorable consistency across all comparisons. The details are provided in Supplementary Material, Table S6. Convergence diagnostics were performed for the primary outcomes, and all R-hat values were close to 1, indicating model convergence (Supplementary Material, Figure S1-S4). Sensitivity analyses were conducted to evaluate the robustness of the results. After excluding studies that used data transformation, CPB ranked first for OME within 24\u00a0h postoperatively. Nonetheless, the number of included articles was small, and thus the results should be cautiously interpreted. No further analyses were performed for dynamic and static pain scores within 24\u00a0h postoperatively because network nodes were connected. The details are provided in Supplementary Material, Table S7-8. Publication bias was evaluated for all outcome measures using funnel plots. The funnel plots for all outcomes were symmetric, indicating insignificant publication bias (Fig.\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2#Fig7\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>). Egger\u2019s test also indicated no publication bias for the 24-hour postoperative static pain scores (p\u2009=\u20090.104), 24-hour postoperative dynamic pain scores (p\u2009=\u20090.803), 24-hour postoperative OME (p\u2009=\u20090.884), postoperative nausea (p\u2009=\u20090.397) and postoperative vomiting (p\u2009=\u20090.745) (Supplementary Material, Figure S5-S9). In addition, overall heterogeneity testing was performed for the main outcomes. The global heterogeneity (I2) for 24-hour postoperative static pain scores, 24-hour postoperative dynamic pain scores, 24-hour postoperative OME, postoperative nausea and postoperative vomiting was 63.1%, 92.0%, 79.1%, 54.7%, and 79.1% respectively (Supplementary Material, Figures S10-S14). Moderate heterogeneity was observed for the 24-hour postoperative static pain scores and postoperative nausea, which was acceptable for network meta-analysis. Given the high heterogeneity of 24-hour postoperative static pain scores, 24-hour postoperative OME and postoperative vomiting, regression analyses were conducted using data transformation and anesthesia method as covariates to explore potential sources of heterogeneity (Supplementary Material, Table S9). The analyses showed that none of these covariates accounted for the observed heterogeneity.<\/p>\n<p><b id=\"Fig7\" class=\"c-article-section__figure-caption\" data-test=\"figure-caption-text\">Fig. 7<\/b><a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03395-2\/figures\/7\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig7\" src=\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/10\/12871_2025_3395_Fig7_HTML.png\" alt=\"figure 7\" loading=\"lazy\" width=\"685\" height=\"359\"\/><\/a><\/p>\n<p>Funnel plot. <b>A<\/b>\u00a024-hour dynamic pain score after surgery; <b>B<\/b> 24-hour static pain score after surgery; <b>C<\/b>\u00a024-hour OME after surgery; <b>D<\/b>\u00a0Postoperative nausea; <b>E<\/b>\u00a0Postoperative vomiting<\/p>\n","protected":false},"excerpt":{"rendered":"Literature retrieval and screening process The initial literature search yielded 2,679 articles. After removing 1,115 duplicate records, the&hellip;\n","protected":false},"author":2,"featured_media":142917,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[74],"tags":[72535,13250,18,28667,46043,19,61134,1911,17,84632,84633,84631,82],"class_list":{"0":"post-142916","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-technology","8":"tag-anesthesiology","9":"tag-efficacy","10":"tag-eire","11":"tag-emergency-medicine","12":"tag-hip-surgery","13":"tag-ie","14":"tag-intensive-critical-care-medicine","15":"tag-internal-medicine","16":"tag-ireland","17":"tag-nerve-block","18":"tag-network-meta-analysis","19":"tag-postoperative-analgesia","20":"tag-technology"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@ie\/115429654364448791","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/142916","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/comments?post=142916"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/142916\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media\/142917"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media?parent=142916"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/categories?post=142916"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/tags?post=142916"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}