Preoperative Fluoroscopy Guided Hip Articular Branch Blocks and Analgesic Outcomes Following Hip Arthroscopy

Study Overview
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Brief Summary
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Arthroscopic hip surgeries are increasingly being performed as both diagnostic and therapeutic interventions. These procedures are considerably painful, thus requiring the proper pain management techniques in order to provide patient satisfaction and sufficient pain control. Articular branch blocks have not been evaluated for their use in hip arthroscopy, but have potential advantages of blocking the sensory innervation of the entire hip joint, with minimal impact on motor innervation compared to alternative blocks. This current study aims to evaluate the efficacy of using preoperative fluoroscopic-guided blockade of articular branches of the femoral and obturator nerves for analgesic management of patients undergoing arthroscopy compared to a saline sham block. The utility of pre-operative hip articular branch block (ABB) prior to hip arthroscopy will provide superior pain management postoperatively compared to a saline sham block. We hypothesize that the ABB (Articular Branch Block) will reduce the area under the NRS pain scores by time curve (AUC) and decreased oral opioid milligram equivalent use in the first 24 hours post-operatively.

Official Title
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Preoperative Fluoroscopy Guided Hip Articular Branch Blocks and Analgesic Outcomes Following Hip Arthroscopy: A Randomized, Controlled Trial

Conditions
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Surgery, Arthroscopic, Analgesia, Pain, Acute

Intervention / Treatment
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* Other: Control
* Other: Articular Branch Block (ABB)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Presenting for Hip Arthroscopy (Diagnostic or Therapeutic) Pre-operative Numeric Rating Score (NRS) for pain <8 on a 0 to 10 scale where 0 is no pain and 10 is worst pain imaginable. Exclusion Criteria: Allergies to any of the study medications Anti-coagulation status (INR > 1.1, PT or APTT > 1.5 control) History of Hip Arthroplasty Infection of Hip Evidence of tumor Pregnancy History of diabetes with HbA1c > 10% Prior history of Hip Articular Branch Blockade or Hip Articular Branch PRF Ablation

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: Sham Injection<br>20cc of Normal Saline 0.9% | Other: Control<br>* Saline Articular Nerve Branch Block<br>|
| Experimental: Articular Branch Block (ABB)<br>20cc of 0.5% Bupivacaine with epinephrine 1:200,000 | Other: Articular Branch Block (ABB)<br>* 0.5% Bupivacaine with epinephrine 1:200,000 (Articular Branch Block)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NRS Pain Scores (NRS) | Numerical Rating Scale is a self-reported pain assessment, in which a patient indicates their current pain level experienced. Patients can rate their pain on a scale of 0 (no pain) to 10 (worse pain imaginable). Higher scores indicated on this scale may indicate that a patient is experiencing higher pain intensities at that particular point in time. Whereas lower reported scores indicate that the patient is experiencing less intense or minimal pain. | 24 hours post-operatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The QOR-15 (Quality of Recovery) | Quality of Recovery scores will be obtained 24 hours post-operatively. Scores are reported on an 11 point scale (0 to 10), where 0 = none of the time and 10 = all of the time. Higher scores indicated on the Quality of Recovery scale represent a better recovery outcome. | 24 hours post-operatively | 
| Analgesic medication use |  | 24 hours post-operatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hip arthroscopy, articular branch block