SFIB vs Anterior QLB in Total Hip Arthroplasty

Samsun University65 enrolled

Overview

Quadratus lumborum block (QLB) is a facial plane block defined to provide analgesia from T7-L3 dermatomes. There are articles reporting that it is an effective analgesic method in hip surgeries. Suprainguinal fascia iliaca block (SIFIB) also blocks components of the lumbar plexus and provides effective analgesia in hip surgeries. The investigators aim to compare the effectiveness of QLB and SIFIB in patients undergoing primary total hip arthroplasty (THA).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Pain

Interventions

Ultrasound Guided Suprainguinal Fascia iliaca BlockPROCEDURE

Patients in this group will be administered SFIB with 50 mL of local anesthetic solution (Bupivacaine %0.25) under ultrasound guidance after the surgery is completed.

Ultrasound Guided Anterior Quadratus Lumborum BlockPROCEDURE

Patients in this group will be administered anterior QLB with 40 mL of local anesthetic (Bupivacaine %0.25) under ultrasound guidance after the surgery is completed.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists (ASA) classification I-II-III * Scheduled for total hip artroplasty surgery under spinal anesthesia Exclusion Criteria: * Patients who did not want to participate in the study * Patients with cognitive dysfunction who cannot evaluate the NRS score and cannot use PCA * Known local anesthetics and opioid allergy, * Pregnancy or lactation * Patients with a contraindication to spinal and regional anesthesia * Presence of multiple fractures

Locations (1)

Samsun University

Samsun, Turkey (Türkiye)

Outcomes

Primary Outcomes

Cumulative opioid comsumption

Morphine consumptions for both group will be recorded

Time frame: up to 24 hour

Secondary Outcomes

Numeric rating scale for postoperative pain intensity

Changes in Numeric Rating Scale (NRS) at rest and on movement will be recorded at intervals. (3-6-12-18-24th hour) NRS is a unidimensional measure of pain intensity in adults. The NRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").

Time frame: up to 24 hours

Quality of Recovery (QoR-15)

The impact of surgical and anesthetic interventions on perioperative quality of life and ability to resume routine life activities will be assessed using the Quality of Recovery (QoR) tool. The QoR-15 scale is a patient-based outcome measure in the form of a 15-item validated questionnaire.

Time frame: at 24th hour

Presence of quadriceps motor block (defined as paralysis or paresis).

Quadriceps motor function will be tested with the patient supine and with the hip and knee flexed at 45º and 90º, respectively. The subject will be asked to extend the knee first against gravity and then against resistance. Quadriceps strength will be graded according to a 3-point scale: normal strength = 0 point (extension against resistance); paresis = 1 point (extension against gravity but not against resistance); and paralysis = 2 points (no extension).

Time frame: up to 24 hours

Data from ClinicalTrials.gov

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