Supra-inguinal Fascia Iliaca Compartment Block on Postoperative Management in Total Hip Arthroplasty by Posterior Approach

Study Overview
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Brief Summary
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Find the impact of supra-inguinal fascia iliaca compartment block on postoperative pain management after total hip arthroplasty by posterior surgical approach

Detailed Description
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ASA physical status 1, 2 and 3 patients scheduled to undergo elective surgery of total hip arthroplasty under spinal anesthesia. The investigators would like to study the impact of supra-inguinal fascia iliaca block on postoperative pain management after total hip arthroplasty by posterior surgical approach. The principal investigator perform this block with ultrasound technique. The investigators also want to observe if this loco-regional new approach to fascia iliaca block could have influence on opioid side effects, postoperative nausea and vomiting, length of hospitalisation and first mobilisation side effects.

Official Title
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Impact of Supra-inguinal Fascia Iliaca Compartment Block on Postoperative Opioid Consumption in Total Hip Arthroplasty Interventions by Posterior Approach

Conditions
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Arthropathy of Hip

Intervention / Treatment
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* Procedure: Supra-inguinal fascia iliaca compartment block
* Drug: Multimodal analgesia and PCA morphine pump


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults patients scheduled to undergo elective surgery of total hip arthroplasty by posterior surgical aboard Exclusion Criteria: Patient refusal Allergy to used medications or local infection. Pregnancy Obesity with body mass index > 35 History of chronic pain or fibromyalgia Drug (opioids) addiction Treatment with corticosteroids for more than 6 months Severe kidney or liver diseases Mental disorders or serious neurological diseases

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 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: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Placebo<br>Placebo group: patients have multimodal analgesia without fascia-iliaca compartment block | Drug: Multimodal analgesia and PCA morphine pump<br>* Patients in placebo group have classical multimodal approach to postoperative analgesia with morphine administration by PCA pump<br>|
| Experimental: Fascia iliaca block<br>Patients in this arm have multimodal analgesia with supra-inguinal fascia iliaca compartment block before surgery | Procedure: Supra-inguinal fascia iliaca compartment block<br>* Ultrasound guided loco-regional technique as described by Desmet et al. Fascia iliaca compartment block with in-plane 40 ml ropivacaine 0,375% injection between the ilio-psoas muscle and the internal oblique muscle. Patients in SFICB group have classical multimodal approach to postoperative analgesia with morphine administration by PCA pump<br>Drug: Multimodal analgesia and PCA morphine pump<br>* Patients in placebo group have classical multimodal approach to postoperative analgesia with morphine administration by PCA pump<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Opioid sparing | Difference in cumulated morphine consumption in the first 48 hours after surgery | 48 hours after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Opioid secondaries effects | incidence of secondary effects related to morphine consumption | 48 hours after the intervention | 
| Pain management satisfaction: questionnaire | pain management satisfaction score by IPO (International Pain Outcomes) questionnaire | 48 hours after the intervention |