QLESP Block Versus Periarticular Infiltration for Postoperative Analgesia in Hip Surgery

NCT06688136 | Completed DMC

• 1 other identifier: WHUH20241101
• Study Type: interventional
• Target: 68
• Locations: 1 country
• Sites: 1

Brief Summary

Local and/or regional analgesia techniques are critical components of an optimal multimodal analgesia technique, as they have been shown to improve pain relief as well as reduce opioid requirements. Optimal pain management technique balances pain relief with concerns about safety and adverse effects associated with analgesic techniques. Periarticular infiltration (PAI) is increasingly included as a component of multimodal analgesia technique for patients undergoing THA, as it provides improved postoperative pain relief with no effects on quadriceps function. Recently, our group has developed a novel transmuscular quadratus lumborum and modified erector spinae plane (QLESP) block, which is characterized by simple operation, high efficiency, and wide dermatomal coverage of sensory block. Therefore, we designed a randomized controlled trial to compare ultrasound-guided QLESP with PAI as a component of non-opioid analgesic regimen in patients undergoing THA via posterior approach. We hypothesized that QLESP would provide superior analgesia when compared with PAI. The primary outcome of the study was postoperative opioid requirements within the initial 24-h postoperative period after THA. The secondary objectives were to compare pain scores, postoperative quadriceps strength, the time to first rescue analgesia, opioid-related adverse effects, time to ambulation, and the time to hospital discharge.

Conditions

Regional Anaesthesia

Outcome Measures

Primary Outcomes (1)

• The cumulative opioid consumption

  At 24 postoperative hours

Secondary Outcomes (3)

• The pain scores determined by the numeric rating scale (NRS, 0-10)

  Postoperative 48 hours

• Quadriceps strength

  Postoperative 48 hours

• Postoperative hospital length of stay

  Up to 6 weeks

Study Arms (2)

transmuscular quadratus lumborum and modified erector spinae plane (QLESP) block

EXPERIMENTAL

Twenty ml of 0.4% ropivacaine was administered between the erector spinae muscle and the transverse process. Twenty ml of 0.4% ropivacaine was subsequently given between the quadratus lumborum and the psoas major muscles.

Drug: ropivacaine

Infiltration

ACTIVE COMPARATOR

Periarticular infiltration of 40 ml of 0.4% ropivacaine prior to closing the incision

Drug: ropivacaine

Interventions

ropivacaine DRUG

Ropivacaine 200 mg diluted to 50 mL

Infiltration; transmuscular quadratus lumborum and modified erector spinae plane (QLESP) block

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18-65 yrs
• American Society of Anesthesiologists classification 1-3
• Body mass index between 20 and 35 (kg/m2)
• Undergo elective primary unilateral THA via a posterolateral approach
• Informed consent

You may not qualify if:

• A known allergy to the drugs being used
• Pre-existing neuropsychiatric disorders or language barrier
• Analgesics intake, history of substance abuse
• Contraindications to peripheral nerve block
• Acute cerebrovascular disease
• Severe liver failure

Sponsors & Collaborators

• Huazhong University of Science and Technology: lead

Study Sites (1)

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, 430022, China

Location

MeSH Terms

Interventions

Ropivacaine

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Study Officials

• Xi Wu

  Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Huazhong University of Science and Technology

Study Record Dates

• First Submitted: November 11, 2024
• First Posted: November 14, 2024
• Study Start: November 18, 2024
• Primary Completion: September 5, 2025
• Study Completion: September 5, 2025
• Last Updated: September 9, 2025

Record last verified: 2024-11

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)