Fascia Iliaca Versus Quadratus Lumborum Block for Pain Management in Total Hip Replacement.

NCT05504525 | Completed

• 1 other identifier: R118/2021
• Study Type: interventional
• Target: 68
• Locations: 1 country
• Sites: 1

Brief Summary

Postoperative analgesia is essential for early ambulation of patients with hip arthroplasties as well as decreasing hospital stay time. Fascial plane blocks are emerging as a gold standard for postoperative analgesia instead of opioids and NSAIDs, with all there side effects. The investigators aim to compare postoperative pain levels and opioid analgesic needs of fascia iliaca block versus quadratus lumborum block in patients undergoing primary total hip arthroplasty under general anesthesia.

Conditions

Postoperative Opioid Requirements in Patients With Traumatic Fracture Hip

Keywords

opioid requirements

Outcome Measures

Primary Outcomes (1)

• Duration of postoperative analgesia

  The investigators will measure the time to first analgesic request after giving the block

  24 hours

Secondary Outcomes (2)

• Total rescue analgesic requirements

  24 hours

• Functional recovery

  72 hours

Study Arms (2)

Fascia iliaca block for postoperative pain management in hip arthroplasty

ACTIVE COMPARATOR

Procedure: Fascia Iliaca block

Quadratus lumborum block for postoperative pain management in hip arthroplasty

ACTIVE COMPARATOR

Procedure: Quadratus lumborum block

Interventions

Fascia Iliaca block PROCEDURE

Ultrasound guided fascia iliaca block done by palpation of anterior superior iliac spine to identify the inguinal crease, then place the ultrasound probe on it to identify the sartorius muscle. Sonographic anatomy will be identified, from superficial to deep, consisting of subcutaneous fat, the internal oblique muscle, the transverse abdominis muscle, the fascia iliaca covering the iliacus muscle and the iliacus muscle itself. The block needle will be advanced in out-of plane to puncture the fascia iliaca. With the needle tip just below the fascia iliaca, 2 ml of a local anesthetic will be injected to confirm the tip location. Once the proper position is confirmed, 40 ml of bupivacaine 0.25% will be injected superficial to the iliacus muscle and deep to the fascia iliaca.

Fascia iliaca block for postoperative pain management in hip arthroplasty

Quadratus lumborum block PROCEDURE

The patients will receive anterior ultrasound guided quadratus lumborum block QLB in the lateral position. The transducer will be first placed in a parasagittal orientation 3-4 cm lateral to the midline and over the sacrum to identify the L5 transverse process. The probe will then rotated into a transverse orientation with slight medial and caudal angulation to obtain a transverse oblique view at L5 transverse process .The ultrasound probe will be tilted , so the lateral end of the probe will be more cranial than the medial side of the probe to avoid the acoustic shadow of the iliac crest. Identify the quadratus lumborum and psoas major and inject the local anesthetic above the QL

Quadratus lumborum block for postoperative pain management in hip arthroplasty

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• All patients aging between 40-60 years ASA II, III with no known hypersensitivity for local anesthetics

You may not qualify if:

• Patient refusal
• Known allergy to local anesthetics
• Previous femoral artery surgery
• Local infection at the site of injection
• Those on anticoagulation therapy

Sponsors & Collaborators

• Ain Shams University: lead

Study Sites (1)

Ain Shams university hospitals

Cairo, 11566, Egypt

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: June 4, 2022
• First Posted: August 17, 2022
• Study Start: May 30, 2022
• Primary Completion: December 3, 2022
• Study Completion: December 30, 2022
• Last Updated: January 20, 2023

Record last verified: 2023-01

Locations

EG (1)