Ultrasound Guided Quadratus Lumborum Block for Post Operative Analgesia After Hip Arthroplasty

Pain, Postoperative Clinical Trial

Official title:

Randomized, Controlled, Double Blind Trial of Ultrasound Guided Quadratus Lumborum Block for Post Operative Analgesia After Hip Arthroplasty

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03502369
• Other study ID #: 050108004
• Status: Recruiting
• Phase: N/A
• First received: April 11, 2018
• Last updated: April 17, 2018
• Start date: September 2018
• Est. completion date: March 2019

Study information

• Verified date: April 2018
• Source: Alexandria University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The study evaluates the effectiveness of anterior quadratus lumborum block for post operative analgesia after hip arthroplasty. Half of the participants will receive ultrasound guided anterior quadratus lumborum block using 30ml bupivacaine 0.375%, while the other half will not receive the block ( control group).

Description:

Sensory innervation of the hip region involves branches of the lumbar plexus and sacral plexus. Effective post operative analgesia can be approached by blocking the lumbar plexus at the level of the quadratus lumborum muscle. Quadratus lumborum block has several approach methods (anterior, lateral, posterior, and intramuscular). Anterior quadratus lumborum block also known as transmuscular QL block or QL3, the local anaesthetic (30ml of bupivacaine 0.375%) is injected between the psoas major muscle (PM) and the quadratus lumborum muscle (QL). Therefore, the anterior quadratus lumborum block may generate analgesia from T10 to L4 covering the sensory innervation of the hip region.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 90
• Est. completion date: March 2019
• Est. primary completion date: January 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

• American society of anesthesiologists physical status |-||| , scheduled to undergo unilateral hip replacement via lateral approach.

Exclusion Criteria:

• patient refusal.

• History of neurological/neuromuscular, psychiatric, dementia preventing proper comprehension.

• coagulation disorders.

• History of allergy to the study medication.

• Infection overlying the injection site.

Related Conditions & MeSH terms

• Pain, Postoperative

Intervention

Procedure:
• Anterior Quadratus lamborum block
Local anaesthetic will be injected in the fascial plane between psoas major muscle and quadratus lumborum muscle.

Locations

Country	Name	City	State
Egypt	Alexandria faculty of medicine	Alexandria

Sponsors (1)

Lead Sponsor	Collaborator
Alexandria University

Country where clinical trial is conducted

Egypt, 

References & Publications (2)

Sauter AR, Ullensvang K, Niemi G, Lorentzen HT, Bendtsen TF, Børglum J, Pripp AH, Romundstad L. The Shamrock lumbar plexus block: A dose-finding study. Eur J Anaesthesiol. 2015 Nov;32(11):764-70. doi: 10.1097/EJA.0000000000000265. — View Citation

Ueshima H, Otake H, Lin JA. Ultrasound-Guided Quadratus Lumborum Block: An Updated Review of Anatomy and Techniques. Biomed Res Int. 2017;2017:2752876. doi: 10.1155/2017/2752876. Epub 2017 Jan 3. Review. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Patient satisfaction.	Patient satisfaction with pain control will be assessed on a four point scale 1.Excellent 2.Good 3.fair 4.poor	every hour in the first 4 post operative hours and then every 4 hours for the rest of the 24 post operative hours.
Primary	Pain intensity assessment	Patients will be trained to use visual analogue scale which consists of 10cm line, 0 cm equivalent to no pain and 10 cm denoting the worst imaginable pain.	every hour for the first 4 post operative hours and then every 4 hours for the rest of the 24 post operative hours.
Secondary	Total amount of post operative morphine (mg).	Total amount of post operative morphine (mg) used as rescue analgesia and the first time of its request.	any time in the first 24 post operative hours.