Evaluation of Anterior Quadratus Lumborum Block for Postoperative Analgesia in Hip Arthroscopy

Hospital for Special Surgery, New York96 enrolled

Overview

Hip arthroscopy is performed frequently and the postoperative course often involves moderate to severe pain. There remains no definitive perioperative pain regimen that has been proven to be effective and safe for this ambulatory procedure. Some institutions perform peripheral nerve blocks either preoperatively or postoperatively as a rescue block. All of these PNBs lead to quadriceps weakness which may impede earlier mobilization and physical therapy. While some case reports exist, there have not been any studies evaluating the QLB for hip arthroscopy patients. As previously mentioned, the technique is easy to perform, well-tolerated by patients, and avoids side effects such as hypotension, urinary retention, or the quadriceps weakness associated with lumbar plexus blockade.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Hip Disease

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients scheduled for hip arthroscopy * Ability to follow study protocol * English Speaking Exclusion Criteria: * Hepatic or renal insufficiency * Younger than 18 years old and older than 80 * Allergy or intolerance to one of the study medications * Chronic gabapentin/pregabalin use (regular use for longer than 3 months) * Chronic opioid use (daily opioids use for longer than 3 months) * Patients contraindicated to undergo a spinal anesthetic * Non English Speakers

Outcomes

Primary Outcomes

Numerical Pain Rating System (NRS) Pain Scores

Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

Time frame: 30min after Post Anesthesia Care Unite (PACU) arrival

Numerical Pain Rating System (NRS) Pain Scores

Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

Time frame: 1 hour after Post Anesthesia Care Unite (PACU) arrival

Numerical Pain Rating System (NRS) Pain Scores

Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

Time frame: 2 hours after Post Anesthesia Care Unite (PACU) arrival

Numerical Pain Rating System (NRS) Pain Scores

Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

Time frame: 3 hours after Post Anesthesia Care Unite (PACU) arrival

Numerical Pain Rating System (NRS) Pain Scores

Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

Time frame: 24 hours after Post Anesthesia Care Unite (PACU) arrival

Secondary Outcomes

Opioid Use

Amount of opioids taken after surgery

Time frame: After Surgery to Post Operative Day 1

Number of Patients With Presence of IAFE (Intraabdominal Fluid Extravasation) Following Surgery

Time frame: Immediately post-op in OR

Number of Patients With Nausea/Vomiting