Quadratus Lumborum Block for Total Hip Arthroplasty

Study Overview
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Brief Summary
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The quadratus lumborum (QL) block is a fascial plane block that has been described to provide analgesia from T7-L3 dermatomes. The investigators aim to evaluate the efficacy of QL blocks in patients undergoing primary total hip arthroplasty (THA).

Detailed Description
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Investigators will enroll subjects planned for primary THA and allocate them into receiving a QL block with either saline or ropivacaine. Primary outcome will be pain scores over the first 48 hours after surgery.

Official Title
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Quadratus Lumborum (QL) Nerve Block for Patients Undergoing Primary Total Hip Arthroplasty (THA)

Conditions
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Pain, Postoperative

Intervention / Treatment
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* Drug: Active Comparator
* Drug: Placebo Comparator


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult subjects undergoing elective primary total hip arthroplasty Exclusion Criteria: patients age < 18, documented allergy to local anesthetic presence of peripheral neuropathy patients with current long term opioid use defined as receiving an opioid on most days in a 90 day period patients with a contraindication to spinal and regional anesthesia such as coagulopathy or infection at the site of the regional technique.

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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Intervention Group<br>Quadratus lumborum nerve block with 0.25% ropivacaine | Drug: Active Comparator<br>* QL block with 0.25% ropivacaine<br>|
| Placebo Comparator: Control Group<br>Quadratus lumborum nerve block with saline | Drug: Placebo Comparator<br>* QL block with saline<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain score | Pain scores will be assessed over 48hrs postop using the visual analog score | Up to 48 hrs post op | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Opioid usage | Total morphine-equivalent will be calculated at 0-24hrs and 24-48hrs postop. | Up to 48 hrs post op | 
| Time to first stand | The period between the end of surgery and the patient's first successful attempt at standing, with or without the assistance of devices (i.e. walker, cane) or staff assistance. | Up to 1 week post surgery | 
| Time to first ambulation | Time to first ambulation of 50 feet or more, with or without the help of assist devices (i.e. walker, cane) or staff assistance. | Up to 1 week post surgery | 
| Ambulation distance | This data point will be measured in feet and will be determined by the distance ambulated during the patient's first ambulation attempt after surgery, regardless of the length of ambulation (This distance will be counted regardless of whether the patient reaches the 50 feet requirement to be counted as the time to first ambulation). | Up to 1 week post surgery | 
| Length of hospital stay | Number of days in the hospital from postoperative day 0 to discharge | Until discharge from hospital, up to 1 week post surgery | 
| Patient satisfaction | Patient satisfaction score will be assessed on day of discharge as measured by a 5-point scale with 1 = terrible, 2 = poor, 3 = satisfactory, 4 = good, and 5 = excellent. | Until day of discharge from the hospital, up to 1 week post surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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quadratus lumborum nerve block, analgesia, total hip arthroplasty, postoperative outcomes