QIPB vs SI-FICB for Postoperative Analgesia After Total Hip Arthroplasty

NCT07683663 | Not Yet Recruiting

• 1 other identifier: 2026/11-01
• Study Type: interventional
• Target: 84
• Locations: 1 country
• Sites: 1

Brief Summary

Total hip arthroplasty (THA) causes moderate-to-severe postoperative pain. The PROSPECT guideline recommends the supra-inguinal fascia iliaca compartment block (SI-FICB) for THA, whereas evidence for newer quadratus-lumborum-family blocks is limited. The quadro-iliac plane block (QIPB) is a recently described fascial plane block, and no study has compared QIPB with SI-FICB head-to-head in any surgical context. In this prospective, double-blind, patients undergoing elective THA who receive one of the two routinely used preoperative blocks (SI-FICB or QIPB, chosen by the attending anesthesiologist as part of routine care) are systematically observed and compared. The primary objective is to assess whether the postoperative analgesic efficacy of QIPB is non-inferior to SI-FICB, using the resting NRS pain score at 6 hours postoperatively as the primary endpoint (non-inferiority margin Δ = 1.3).

Conditions

Hip Osteoarthritis; Postoperative Pain; Acute Pain; Total Hip Arthroplasty (THA)

Keywords

regional anesthesia; quadro-iliac plane block; fascia iliaca block; opioid consumption; quality of recovery

Outcome Measures

Primary Outcomes (1)

• Pain intensity at rest at 6 hours postoperatively

  Numeric Rating Scale (NRS), 0 = no pain to 10 = worst imaginable pain, measured at rest by a blinded assessor. Non-inferiority margin Δ = 1.3 NRS points.

  6 hours after surgery

Secondary Outcomes (3)

• NRS pain at rest

  0, 2, 4, 6, 12, 24, 48 hours postoperatively

• NRS pain on movement (active hip flexion)

  0, 2, 4, 6, 12, 24, 48 hours postoperatively

• Cumulative opioid consumption

  24 hours and 48 hours

Study Arms (2)

SI-FICB

ACTIVE COMPARATOR

Patients receiving supra-inguinal fascia iliaca compartment block (single-shot, US-guided, 40 mL 0.25% bupivacaine, preoperative).

Procedure: Supra-Inguinal Fascia Iliaca Compartment Block

QIPB

EXPERIMENTAL

Patients receiving quadro-iliac plane block (single-shot, US-guided, 40 mL 0.25% bupivacaine, preoperative).

Procedure: Quadro-Iliac Plane Block

Interventions

Supra-Inguinal Fascia Iliaca Compartment Block PROCEDURE

SIFICB is an ultrasound-guided fascial plane block performed via a supra-inguinal approach to the iliac fascia compartment, targeting the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve. Single-shot, US-guided, 40 mL 0.25% bupivacaine, before GA induction.

SI-FICB

Quadro-Iliac Plane Block PROCEDURE

QIPB is a facial plane block performed under ultrasound guidance with local anesthetic in the interfascial plane between the erector spinae and the quadratus lumborum muscle, at the distal attachment site of the quadratus lumborum muscle on the iliac crest. Single-shot, US-guided, 40 mL 0.25% bupivacaine, before GA induction.

QIPB

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 18-75 years
• Scheduled for elective primary total hip arthroplasty
• ASA physical status I-III
• Able to understand and communicate in Turkish and complete assessment scales
• Completed preoperative anesthesia evaluation and approved for surgery
• Signed written informed consent

You may not qualify if:

• Known allergy/contraindication to any local anesthetic, including bupivacaine
• Coagulopathy or anticoagulant/antiplatelet therapy contraindicating block (per ASRA 2022)
• Active infection or skin breakdown at the block site
• Chronic opioid use (≥3 months daily) or history of opioid dependence
• Morbid obesity (BMI \> 40 kg/m²)
• Cognitive impairment or communication difficulty precluding reliable NRS/QoR-15 assessment
• Pregnancy or breastfeeding
• Revision THA or emergency THA for fracture
• Intraoperative complications requiring major protocol deviation (e.g., \>1000 mL blood loss, cardiac arrest)
• Technically failed block (no sensory change at any region on the T1 cold test)

Sponsors & Collaborators

• Dokuz Eylul University: lead

Study Sites (1)

Dokuz Eylül University

Izmir, Balçova, 35340, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Osteoarthritis, Hip; Pain, Postoperative; Acute Pain

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Onur Küçük, associate professor

  Dokuz Eylul University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Onur Küçük, associate professor

CONTACT

5358543333; onur.kucuk@deu.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: June 23, 2026
• First Posted: July 6, 2026
• Study Start: June 30, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): June 1, 2027
• Last Updated: July 6, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)