CPB for Arthroscopic Hip Surgery

N/ANot Yet RecruitingNCT06337968

The Second Hospital of Shandong University74 enrolled

Overview

Arthroscopic hip surgery is being increasingly performed to treat both intraarticular and extraarticular hip diseases. Despite the minimally invasive approach, patients undergoing arthroscopic hip surgery still suffer severe pain due to the complex nature of hip innervation. Postoperative pain reduces patient satisfaction and delay patient recovery and discharge. The efficacy of regional anesthesia techniques in postoperative pain management have been proved in various surgeries. However, it remains controversial whether or not peripheral nerve blocks can significantly improve postoperative analgesia after hip arthroscopy. Several studies have shown that the fascia iliac block cannot improve postoperative analgesia for hip arthroscopy because it blocks only some branches of the lumbar plexus but not the sacral plexus. Circum-Psoas Block (CPB) which has been defined in recent years is able to block the lumbar plexus nerves as well as sacral plexus such as the sciatic, superior gluteal, and inferior gluteal nerves. Therefore, the investigators predict that it can provide effective postoperative analgesia for hip arthroscopy. In this study, the researchers aim to investigate the effectiveness of CPB in hip arthroscopy.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Acute Pain Opioid Use

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Primary unilateral ambulatory hip arthroscopy * Age 18 to 70 years * ASA physical status I to III * Ability to follow the protocol. Exclusion Criteria: * Age \<18 or \>70 years of age * BMI above 40 * Contraindications to peripheral nerve blockade * Pregnancy * Chronic pain condition requiring opioid intake at home * Allergy to opioids or local anesthetics * Patient refusal

Outcomes

Primary Outcomes

pain severity at 6 hours postoperatively

Postoperative pain assessed with NRS pain score (NRS 0: no pain 10: pain as bad as can be) at 1, 6, 12, 24 hours postoperatively. However, to be more precise in our assessment, the effectiveness of each intervention was defined as a reduction in the pain at 6 hours postoperatively.

Time frame: 6 hours postoperatively

Secondary Outcomes

Postoperative opioid consumption

Cumulative 24-hr postoperative opioid consumption

Time frame: up to the first 24 hours postoperatively

Postoperative nausea and vomiting

Nausea and vomiting intensity score measured by numeric rank score (0:no nausea and no vomiting, 1: have nausea, no vomiting, 2: once vomiting, 3: two or more vomiting).

Time frame: up to the first 24 hours postoperatively

neurologic evaluation

The dermatomal coverage of sensory block was evaluated by using a cool roller at 1, 6, 24 hours post-surgery. Motor strength was assessed by the following criteria (0: none; 1: muscle flicker without movement; 2: movement, but not against gravity; 3: movement against gravity; 4: movement against some resistance; 5: normal strength).

Time frame: 1, 6, 24 hours postoperatively

Patient satisfaction

Patient satisfaction measured using a numeric rating scale 0 to 10 (0 = unsatisfied; 10 =very satisfied)

Time frame: at the end of 24 hours postoperatively