Acetabulum fractures although constitute only 1.5 -3% of geriatric orthopaedic trauma but are on the rise. A large proportion of them are elderly with multiple comorbidities and their associated challenges. It is a painful condition both at rest and on slight movement.  good  perioperative analgesia is mandatory for these patients, like in any other orthopaedic trauma.  Many recipes have been tried for perioperative pain relief ranging from systemic analgesia with or without opioids to multimodal analgesia.  Many regional blocks   like femoral nerve block, 3 in 1, fascia ilaca, supra inguinal fascia ilaca and peri capsular nerve group  block have been tried as part of multimodal analgesia.

These days acetabulum fractures are fixed surgically, anaesthesia of choice for these patients is central neuraxial block and many times combined spinal epidural for both long duration surgeries and postoperative analgesia. For these blocks sitting position is preferable as patients find it difficult to lie on the side. To perform these blocks successfully in one go the patient has to be pain free and comfortable. Systemic analgesia is a choice, but at times it does not offer adequate analgesia and patient sometimes feel a little dizzy if they are given opioids. So we all look forward to good regional blocks for effective analgesia during positioning these patients for central neuraxial blocks.

Blanco introduced the Quadratus Lumborum block in 2007 and it is now emerging as new regional block that has performed favourably in lower abdominal surgery and is being evaluated for hip analgesia.  It is believed to provide pain relief for patients with hip fractures because it has multiple approaches. Cadaveric studies of the QLB showed direct dye spread to the roots and branches of the lumbar plexus; thus, these studies supported the possible benefit of QLB in hip surgeries. However, the anterior approach is being tried because the posterior and lateral approaches are not possible for these patients. The drug is deposited between the quadratus lumborum and the psoas muscle in this block, where it seeps up to the lumbar plexus. Therefore, we wish to assess the effectiveness of analgesia of anterior quadratus lumborum block for positioning patients with fracture acetabulum for spinal anesthesia.