Comparison of Analgesic Efficacy of Suprainguinal Fascia Iliaca and Quadro-iliac Blocks in Hip Fracture Surgery

NCT07546903 | Recruiting

• 1 other identifier: 2025-161
• Study Type: observational
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

Hip fractures are common in the elderly and are associated with significant morbidity and mortality. Effective early analgesia is crucial for facilitating mobilization, reducing pulmonary complications, and improving overall outcomes. Although opioids are traditionally used for postoperative pain management, their adverse effects have led to increased interest in multimodal analgesia, particularly peripheral nerve blocks. The suprainguinal fascia iliaca block (SIFI) is a modified technique that allows wider spread of local anesthetic, providing more effective blockade of the femoral, obturator, and lateral femoral cutaneous nerves. The quadro-iliac plane block (QIPB), a recently described interfascial block, is performed at the level of the anterior superior iliac spine and may also affect branches of the lumbar and sacral plexus. While both techniques have been shown to provide effective analgesia and reduce opioid consumption, there is no study directly comparing them. Therefore, this study aims to compare the postoperative analgesic efficacy of SIFI and QIPB in patients undergoing hip fracture surgery.

Conditions

Post Operative Pain

Keywords

Hip Fracture; Suprainguinal Fascia Iliaca Block; Quadro-Iliac Plane Block

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Assessed by Numeric Rating Scale (NRS)

  Postoperative pain will be evaluated using the Numeric Rating Scale (NRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.

  24 hours postoperatively

Study Arms (2)

Suprainguinal Fascia Iliaca Block (Group S)

The patient will be positioned supine. The application area will be sterilized with 10% povidone-iodine, and the linear ultrasound probe will be covered with a sterile sheath. Using an in-plane technique with a 22-25G, 50-100 mm peripheral nerve block needle, the area between the iliacus muscle and the fascia iliaca will be reached at the level of the anterior superior iliac spine, proximal to the inguinal ligament. Hydrodissection will be performed with 2 mL of saline, followed by the injection of 40 mL of 0.25% bupivacaine.

Procedure: Suprainguinal Fascia Iliaca Block

Quadro-Iliac Plane Block (Group Q):

The patient will be positioned prone. The application area will be sterilized with 10% povidone-iodine, and the linear ultrasound probe will be covered with a sterile sheath. At the level of the L3 vertebra, the probe will be placed just lateral to the spinous process to visualize the erector spinae, quadratus lumborum, and psoas major muscles. A 22-25G, 50-100 mm block needle will be advanced from cranially to caudal using the in-plane technique. After administering 2 mL of saline for hydrodissection, 40 mL of 0.25% bupivacaine will be injected into the plana between the quadratus lumborum and the iliacus muscle. Quadro-Iliac Plane Blocks are generally performed in the prone position. However, depending on the patient's clinical condition or positional tolerance, the lateral decubitus position may be preferred. In both positions, anatomical references and ultrasound imaging will be provided in a standard manner.

Procedure: Quadro-Iliac Plane Block

Interventions

Suprainguinal Fascia Iliaca Block PROCEDURE

the area between the iliacus muscle and the fascia iliaca will be reached at the level of the anterior superior iliac spine, proximal to the inguinal ligament. Hydrodissection will be performed with 2 mL of saline, followed by the injection of 40 mL of 0.25% bupivacaine.

Suprainguinal Fascia Iliaca Block (Group S)

Quadro-Iliac Plane Block PROCEDURE

At the level of the L3 vertebra, the probe will be placed just lateral to the spinous process to visualize the erector spinae, quadratus lumborum, and psoas major muscles.

Quadro-Iliac Plane Block (Group Q):

Eligibility Criteria

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

Study Population

Adult, hemodynamically stable (ASA I-III) patients undergoing hip fracture surgery.

You may qualify if:

• Patients aged 18 years and older
• ASA physical status I-III
• Hemodynamically stable patients
• Scheduled for surgical treatment of hip fracture
• Body mass index (BMI) ≤ 35 kg/m²
• Provided written informed consent

You may not qualify if:

• Refusal to participate
• ASA physical status IV-V
• Hemodynamically unstable patients
• Surgery not completed as planned
• Infection at the block site
• History of allergy to local anesthetics or tramadol
• Presence of neuromuscular or peripheral nerve diseases
• Chronic pain conditions
• Coagulopathy or ongoing anticoagulant therapy
• High-dose opioid use within the last 3 days
• Severe hepatic or renal insufficiency
• Diabetes mellitus
• Pregnancy or breastfeeding
• NRS score \>7 for four consecutive hours despite multimodal analgesia
• Inability to understand or use assessment tools (e.g., NRS, QoR-15)

Sponsors & Collaborators

• Hitit University: lead

Study Sites (1)

Hitit university

Çorum, 19100, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Pain, Postoperative; Hip Fractures

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries

Study Officials

• Ozgur Yagan, Proffesor

  Hitit University

  STUDY CHAIR

Central Study Contacts

MUHAMMED ATICI

CONTACT

+905535716152; dr.matc92@gmail.com

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: April 10, 2026
• First Posted: April 23, 2026
• Study Start: October 20, 2025
• Primary Completion: April 30, 2026
• Study Completion (Estimated): June 15, 2026
• Last Updated: April 23, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)