Pain and Sensation After Regional Anesthesia - Pilot Study

Study Overview
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Brief Summary
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This study aims to determine spinal resolution and pain levels after the placement of a lumbar plexus block (LPB) and spinal for total hip replacement procedure. This is a pilot study that looks to collect information in order to design a larger, more significant study comparing Quadratus Lumborum blocks (QLB) and Lumbar Plexus blocks.

Detailed Description
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The Quadratus Lumborum block (QLB) is a newer regional analgesic technique that may be as effective as Lumbar Plexus blocks (LPB) at providing pain control following direct anterior approach (DAA) hip arthroplasty. The purpose of this study is to collect pilot data to help the design of a future randomized study, comparing a QLB to a LPB for DAA procedures. The investigators will assess for spinal resolution below the level of L5/S1 by assessing the presence of pin prick sensation at these levels. This will help determine if pain scores collected at 6hrs reflect analgesia provided by the preoperative LPB alone or if the data is confounded by the presence of spinal anesthesia. This data will help us determine if 6hrs is a feasible primary endpoint to assess pain scores. Additionally, assuming that spinal regression is complete by 6hrs, the VAS pain scores obtained will then be used to perform a power analysis to determine the necessary study size when comparing QLB to LPB for DAA hip arthroplasty.

Official Title
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Pilot Study on Pain and Sensation After Regional Anesthesia for Total Hip Arthroplasty

Conditions
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Anesthesia, Conduction, Osteoarthritis, Hip

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients that have elective total hip arthroplasty with DAA at Davie Medical Center. Exclusion Criteria: Patients will be excluded if they do not receive a lumbar plexus block and spinal anesthesia. and/or if they have peripheral neuropathy affecting their feet.

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Lumbar Plexus block Group<br>This group includes participants that received Lumbar Plexus blocks (LPB) as the regional analgesic technique in a direct anterior approach (DAA) Total Hip Arthroplasty. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Pain Score With Activity | Pain scores will be measured on a verbal pain score when participant sits up in bed. Totals Score range 0-10. Lower scores denote better outcomes. | 6 Hours post block placement | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Pain Scores at Rest | Pain scores will be measured, when the patient is laying still in bed, on a verbal pain scale. Totals Score range 0-10. Lower scores denote better outcomes. | 6 Hours post block placement | 
| Number of Participants Reporting Pin Prick Sensation | Assessment for spinal resolution below the level of L5/S1 by assessing the presence of pin prick sensation at these levels. | 6 Hours post block placement | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pain, Lumbar Plexus block, total hip arthroplasty, Arthroplasty, direct anterior approach