Deep Iliacus Plane Block Versus Transmuscular Quadratus Lumborum Block for Postoperative Analgesia After Total Hip Arthroplasty

Tanta University80 enrolled

Overview

This study aims to compare the analgesic efficacy, opioid consumption, motor function preservation, and quality of recovery of ultrasound-guided deep iliacus plane block (DIPB) and transmuscular quadratus lumborum block (QLB) in patients undergoing total hip arthroplasty (THA).

Total hip arthroplasty (THA) is one of the most commonly performed orthopedic procedures for the treatment of end-stage hip disorders. It is indicated for conditions such as osteoarthritis, rheumatoid arthritis, avascular necrosis, and femoral neck fractures. The quadratus lumborum block (QLB) is an ultrasound-guided fascial plane block that has been increasingly used for analgesia in hip surgery. The deep iliacus plane block (DIPB) is a recently introduced regional anesthesia technique specifically developed for hip analgesia. The block is performed by depositing local anesthetic in the deep fascial plane between the iliacus muscle and the iliac bone.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Deep Iliacus Plane Block Transmuscular Quadratus Lumborum Block Postoperative Analgesia

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years. * Both sexes. * American Society of Anesthesiologists (ASA) physical status I-III. * Scheduled for elective unilateral total hip arthroplasty (THA) under spinal anesthesia. Exclusion Criteria: * Known allergy to local anesthetics or study medications. * Coagulopathy or anticoagulant therapy contraindicating regional anesthesia. * Infection at the site of injection. * Pre-existing neurological deficits affecting the lower limbs. * Chronic opioid use or opioid dependence. * Severe hepatic, renal, respiratory, or cardiac disease. * Body mass index (BMI) \> 40 kg/m². * Contraindications to spinal anesthesia.

Outcomes

Primary Outcomes

Degree of pain

Time frame: Each patient will be instructed about postoperative pain assessment with VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 12, and 24 h postoperatively.

Secondary Outcomes

Total morphine consumption

Rescue analgesia of morphine will be given as 3 mg bolus if the Visual Analog Scale (VAS) \> 3 to be repeated after 30 min if pain persists until the VAS \< 4.