This study aims to compare the Quadro-Iliac Plane Block versus Erector Spinae Plane Block after total hip arthroplasty.
Total hip arthroplasty (THA) is frequently utilized in elderly patients to address hip pain and restore joint function. Effective postoperative pain management is critical; however, the use of opioids is associated with a range of adverse effects, including nausea, vomiting, pruritus, constipation, respiratory depression, and the risk of dependence. Quadro-iliac plane block (QIPB) has been introduced, combining elements of both posterior and anterior QLB approaches. Erector Spinae Plane Block (ESPB) was initially described as an analgesic approach for managing thoracic neuropathic pain. This innovative fascial block technique enables sensory blockade across multiple abdominal and thoracic wall segments.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
76
Patients will receive ipsilateral Quadro-iliac plane block (QIPB) using 20ml of bupivacaine 0.25%.
Patients will receive ipsilateral erector spinae plane block (ESPB) using 20ml of bupivacaine 0.25%.
Tanta University
Tanta, El-Gharbia, Egypt
RECRUITINGTime to the first rescue analgesia
Time to the first request for the rescue analgesia will be recorded from the end of surgery to first dose of morphine administrated.
Time frame: 24 hours postoperatively
Total morphine consumption
Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.
Time frame: 24 hours postoperatively
Degree of pain
Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 8, 12, 18, and 24 h postoperatively.
Time frame: 24 hours postoperatively
Quality of recovery
The quality of recovery (QoR-15) score, will be assessed 24 hours postoperatively. This tool consists of 15 questions, each scored on a 10-point scale, yielding a maximum of 150. It encompasses five domains; physical comfort (questions 1-4, 13), emotional state (questions 9, 10, 14, 15), psychological support (questions 6, 7), physical independence (questions 5, 8), and pain (questions 11, 12
Time frame: 24 hours postoperatively
Incidence of adverse events
Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, or any other complication will be recorded.
Time frame: 24 hours postoperatively
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