The Efficacy of Suprainguinal Fascia Iliaca Compartment Block for Analgesia After Elective Total Hip Replacement.

Study Overview
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Brief Summary
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Total hip replacement surgery is one of the most common orthopedic interventions. Proper anaesthesia and adequate analgesia is one of the key interests of attending anaesthetist. Recent studies show that ultrasound guided suprainguinal fascia iliaca compartment block may play a significant role in proper management of pain after these procedures. The aim of this study was to assess the clinical usefulness and compare different methods of anaesthesia for total hip replacement surgery via posterolateral approach.

Official Title
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The Efficacy of Ultrasound Guided Suprainguinal Fascia Iliaca Compartment Block for Acute Paint Control After Elective Total Hip Replacement Using Postero-lateral Approach

Conditions
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Anesthesia, Local, Analgesia, Arthropathy of Hip

Intervention / Treatment
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* Other: Opioid and non opioid postoperative analgesia.
* Other: Fascia iliaca compartment block
* Drug: Dexamethasone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age 18-75 years old informed consent to participate in the study ASA score I-III BMI -19-30kg/m2 qualified for total hip replacement no contraindication to used anesthesia and drugs Exclusion Criteria: contraindications to spinal anesthesia and regional blocks previously coexisting chronic pain previously opioids intake BMI>30kg/m2 allergy to drugs using during study mental status preventing the usage of patient controlled analgesia pump

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Opioid and non opioid postoperative analgesia.<br>Group of patients with opioid and non opioid based postoperative analgesia without preoperative regional anaesthesia and dexamethasone. | Other: Opioid and non opioid postoperative analgesia.<br>* Postoperative analgesia will be based on opioid and non opioid analgesics according to standardised protocol.<br>|
| Experimental: Regional anaesthesia, opioid and non opioid postoperative analgesia.<br>Group of patients with opioid and non opioid based postoperative analgesia with preoperative regional anaesthesia and without preoperative dexamethasone. | Other: Opioid and non opioid postoperative analgesia.<br>* Postoperative analgesia will be based on opioid and non opioid analgesics according to standardised protocol.<br>Other: Fascia iliaca compartment block<br>* Ultrasound guided suprainguinal fascia iliaca compartment block will be performed using 0.375% ropivacaine and 5ug/ml adrenaline according to standardised protocol.<br>|
| Experimental: Regional anaesthesia, dexamethasone, opioid and non opioid postoperative analgesia<br>Group of patients with opioid and non opioid based postoperative analgesia with preoperative regional anaesthesia and dexamethasone. | Other: Opioid and non opioid postoperative analgesia.<br>* Postoperative analgesia will be based on opioid and non opioid analgesics according to standardised protocol.<br>Other: Fascia iliaca compartment block<br>* Ultrasound guided suprainguinal fascia iliaca compartment block will be performed using 0.375% ropivacaine and 5ug/ml adrenaline according to standardised protocol.<br>Drug: Dexamethasone<br>* Dexamethasone will be administered preoperatively in a dose of 0,1 mg/kg.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Opioid consumption [mg] | Postoperative opioid consumption was noted. | 48 hours | 
| Opioid related adverse effects | Postoperative incidence of nausea, vomiting, constipation and apnea were noted. | 48 hours | 
| Hospital stay [days] | Total length of hospital stay was noted. | 31 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Likert scale | Likert scale value was noted at the discharge. Value of 1 corresponded with strong dissatisfaction, value of 2 with dissatisfaction, value of 3 with neither satisfaction nor dissatisfaction, value of 4 with satisfaction, value of 5 with strong satisfaction. | 31 days |