Fascia Iliaca Compartment Block Versus Quadratus Lumborum Block in Total Hip Arthroplasty

Pain, Postoperative Clinical Trial

Official title:

Suprainguinal Fascia Iliaca Compartment Block Versus Anterior Quadratus Lumborum Block for Analgesia After Total Hip Arthroplasty: a Randomized Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05228028
• Other study ID #: 2112-062-1282
• Status: Completed
• Phase: N/A
• Start date: March 22, 2022
• Est. completion date: December 22, 2022

Study information

• Verified date: December 2022
• Source: Seoul National University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Patients undergoing total hip arthroplasty are randomly assigned to two groups (fascia iliaca compartement block [FICB] group or quadratus lumborum block [QLB] group). In the FICB group, ultrasound-guided suprainguinal FICB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is performed on the ipsilateral surgical side at the end of surgery. In the QLB group, ultrasound-guided anterior QLB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery. A standardized multimodal analgesic regimen is used for postoperative pain control. The total use of opioids including patient-controlled analgesia and rescue analgesics is compared in both groups for 24 hours after surgery. The amount of opioids used is compared by conversion to oral morphine equivalent dose. Pain score at rest and movement during postoperative 24 hours, time to first request for analgesics, the incidence of side effects, patient satisfaction for pain control at postoperative 24 hours, quality of recovery at postoperative 24 hours, time to discharge readiness, and hospital length of stay are compared.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 80
• Est. completion date: December 22, 2022
• Est. primary completion date: October 21, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 19 Years to 70 Years

Eligibility

Inclusion Criteria:

• Adult patients between the ages of 19 and 70 undergoing total hip arthroplasty under spinal anesthesia
• Be able to provide written consent to participate in clinical trials, understand the procedures of this clinical trial, and be able to properly fill out patient-reported questionnaires
• ASA physical status classification 1-2

Exclusion Criteria:

• ASA physical status classification 3-4
• Patients who are contraindicated to nerve blocks (hypersensitivity to local anesthetics, infection at the injection site, etc.)
• Patients with chronic pain and taking pain medications, antidepressants, and anticonvulsants
• Other major medical or psychiatric conditions that will affect response to treatment
• Refusal of intravenous patient-controlled analgesia
• Patients determined to be unsuitable for this clinical trial by the researchers

Related Conditions & MeSH terms

• Nerve Block
• Pain, Postoperative

Intervention

Procedure:
• fascia iliaca compartement block
Ultrasound-guided suprainguinal FICB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery.
• quadratus lumborum block
Ultrasound-guided anterior QLB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery.

Locations

Country	Name	City	State
Korea, Republic of	Seoul National University Hospital	Seoul

Sponsors (1)

Lead Sponsor	Collaborator
Seoul National University Hospital

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Total opioids use for 24 hours	Total dose of opioids used upto 24 hours after surgery (morphine milligram equivalents)	Over the first 24 hours after surgery
Secondary	Postoperative pain at rest (Numeric rating scale)	Postoperative pain at rest (Numeric rating scale; minimum 0, maximum 10, a higher score means more pain)	At postoperative 4, 8, 12, 16, 20, 24 hours
Secondary	Postoperative pain with movement (Numeric rating scale)	Postoperative pain with movement (Numeric rating scale; minimum 0, maximum 10, a higher score means more pain)	At postoperative 4, 8, 12, 16, 20, 24 hours
Secondary	Time to first request for pain medication	Time to first request for pain medication after surgery	From the end of surgery to discharge, an average of 4 days
Secondary	Incidence of postoperative nausea and vomiting	Incidence of postoperative nausea and vomiting (%)	Over the first 24 hours after surgery
Secondary	Patient satisfaction score with pain control at 24 hours after surgery	Patient satisfaction score with pain control at 24 hours after surgery (minimum 0, maximum 10, a higher score means higher satisfaction)	At 24 hours after surgery
Secondary	Quality of Recovery at 24 hours after surgery	Quality of Recovery at 24 hours after surgery assessed by QoR-15 questionnaire	At 24 hours after surgery
Secondary	Time to discharge readiness	Days of hospitalization after surgery until discharge readiness (defined as satisfying the following three criteria; (1) adequate pain control (numeric rating scale score < 4), (2) no intravenous opioid use in the past 12 hours, and (3) able to walk at least 30 m without time limit)	From the end of surgery to discharge, an average of 4 days
Secondary	Hospital length of stay	Days of hospitalization after surgery until discharge	From the end of surgery to discharge, an average of 4 days