This study aims to compare the analgesic efficacy of supra-iliac anterior quadratus lumborum block (SA-QLB) and pericapsular nerve group (PENG) block in patients undergoing total hip arthroplasty (THA).
Total hip arthroplasty (THA) is one of the most common elective orthopedic procedures, performed to restore mobility, alleviate pain and improve quality of life in patients with degenerative hip joint disease. Its rate is projected to further increase with aging of the population worldwide. Pericapsular nerve group (PENG) block is a fascial block targets periarticular sensory branches derived from the femoral, obturator and accessory obturator nerves innervating the anterior hip capsule. The ultrasound-guided quadratus lumborum block (QLB) is a regional anesthetic technique with many described approaches: the lateral QL (QL1) block, the posterior QL (QL2) block, and the anterior QL (transmuscular) block.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
Patients will receive a supra-iliac anterior quadratus lumborum block (SA-QLB) using 20mL of bupivacaine 0.25%.
Patients will receive an ultrasound-guided pericapsular nerve group (PENG) block using 20mL of bupivacaine 0.25%.
Tanta University
Tanta, El-Gharbia, Egypt
RECRUITINGDegree of pain
Each patient will be instructed about postoperative pain assessment with visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable")
Time frame: 12 hours postoperatively
Total morphine consumption
Rescue analgesia of morphine will be given as 3 mg bolus if the VAS \> 3 to be repeated after 30 min if pain persists until the visual analog scale (VAS) \< 4. VAS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 12, 24, and 48 h postoperatively.
Time frame: 48 hours postoperatively
Time to the first rescue analgesia
Time to the first request for the rescue analgesia will be recorded from the end of block to first dose of morphine administrated.
Time frame: 48 hours postoperatively
Time to ambulation
Time to ambulation will be recorded from the end of surgery to the first successful mobilization of the patient, defined as the ability to stand and walk at least 3-5 steps with or without assistance.
Time frame: Till the first successful mobilization (Up to 4 hours)
Length of hospital stay
Length of hospital stay will be recorded from admission till the discharge from hospital.
Time frame: Till discharge from the hospital (Up to 2 weeks)
Incidence of adverse events
Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication will be recorded.
Time frame: 24 hours postoperatively
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