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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
80
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.
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.
Seoul National University Hospital
Seoul, South Korea
Total opioids use for 24 hours
Total dose of opioids used upto 24 hours after surgery (morphine milligram equivalents)
Time frame: Over the first 24 hours after surgery
Postoperative pain at rest (Numeric rating scale)
Postoperative pain at rest (Numeric rating scale; minimum 0, maximum 10, a higher score means more pain)
Time frame: At postoperative 4, 8, 12, 16, 20, 24 hours
Postoperative pain with movement (Numeric rating scale)
Postoperative pain with movement (Numeric rating scale; minimum 0, maximum 10, a higher score means more pain)
Time frame: At postoperative 4, 8, 12, 16, 20, 24 hours
Time to first request for pain medication
Time to first request for pain medication after surgery
Time frame: From the end of surgery to discharge, an average of 4 days
Incidence of postoperative nausea and vomiting
Incidence of postoperative nausea and vomiting (%)
Time frame: Over the first 24 hours after surgery
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)
Time frame: At 24 hours after surgery
Quality of Recovery at 24 hours after surgery
Quality of Recovery at 24 hours after surgery assessed by QoR-15 questionnaire
Time frame: At 24 hours after surgery
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)
Time frame: From the end of surgery to discharge, an average of 4 days
Hospital length of stay
Days of hospitalization after surgery until discharge
Time frame: From the end of surgery to discharge, an average of 4 days
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