A Study Comparing Fascia Iliaca Blockade vs Extracapsular Local Field Infiltration With Liposomal Bupivacaine

Study Overview
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Brief Summary
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The purpose of this study is to compare the effectiveness of fascia iliaca blockade vs local field infiltration with liposomal bupivicaine in controlling pain, narcotic utilization and falls in the postoperative period following hip arthroscopy

Detailed Description
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The purpose the research is to help determine optimal means of post-operative analgesia following hip arthroscopic procedures. Post-operative pain is a significant contributor to patient satisfaction and the side effects of narcotic pain medication are well described. The ideal intervention for achieving appropriate analgesia following hip arthroscopy has not yet been defined. Determining means of achieving acceptable post-operative pain relief while minimizing narcotic usage will help yield maximal patient outcomes.The primary research procedures entailed in this study include fascia iliaca nerve blockade with Marcaine and local field infiltration with liposomal bupivicane (Exparel). The patients in this study will include those who have both a clinical and radiographic diagnosis of femoracetabular impingement (FAI), have failed non operative treatment, and are indicated for hip arthroscopy with labral repair and femoroplasty/acetabuloplasty. The study includes the surgical procedure and the first post-operative follow up visit. The total study duration is approximately 1.5 weeks for each patient. The study will be carried out until the patients first post-operative visit which typically occurs 7-10 days after the procedure. We are to include approximately 40 patients in total for this study over a period of 4 months.

Official Title
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Pain Outcomes Following Hip Arthroscopy: A Prospective Randomized Control Study Comparing Fascia Iliaca Blockade vs Extracapsular Local Field Infiltration With Liposomal Bupivacaine

Conditions
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Femoro Acetabular Impingement

Intervention / Treatment
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* Drug: liposomal bupivicaine
* Procedure: Fascia iliaca blockade


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult patients (>18 years old) diagnosed FAI that are indicated for hip arthroscopic labral repair and femoroplasty/acetabuloplasty. Exclusion Criteria: patients undergoing revision procedures, bilateral procedures, advanced osteoarthritis (<2mm joint space on plain radiographs) frank dysplasia (anterior and/or lateral center edge angles <20 degrees and/or Tonnis angle >15 degrees) diagnoses other than FAI (Legg Calve Perthes, femoral head avascular necrosis, septic arthritis, or post traumatic deformity). allergy to liposomal bupivicaine

Ages Eligible for Study
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Minimum Age: 18 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Liposomal Bupivicaine<br>Following hip arthroscopy, local field infiltration with liposomal bupivicaine will be performed for adjunct pain control | Drug: liposomal bupivicaine<br>* local field infiltration<br>* Other names: exparel;|
| Active Comparator: fascia iliaca blockade<br>Preoperatively before hip arthroscopy, a fascia iliaca blockade will be performed for adjunct pain control | Procedure: Fascia iliaca blockade<br>* fascia iliaca compartment blockade<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale | pain scale Questionnaire 0 equals no pain at all and 10 equals the worst. The out come measure time frame is reported as the average VAS score of the first 4 day post op. | post op days 1-4 (Average VAS score of first 4 days of post op) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Narcotic Utilization | Record of number of narcotic pain pills utilized by patients . This was reported as a total from post op day 1 to 4. The number listed is an average from each patient, from the total pills taken at home. | total pill taken over the course of days 1-4 post op. | 
| Total Number of at Home Falls. | number of falls occurring at home after discharge. This is the total number of falls of all patients in each group, over the first 7 days post op. This is not reported as a mean. | Post op days 1-7 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hip arthroscopy