Continuous Epidural Analgesia Versus Continuous Supra-Inguinal Fascia Iliaca Block in Total Hip Replacement Surgery

Study Overview
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Brief Summary
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comparison of continuous epidural analgesia and ultrasound guided continuous supra-inguinal fascia iliaca compartment block after total hip replacement surgery

Detailed Description
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supra-inguinal FICB is a promising safe approach for lumbar plexus that may be useful for analgesia in hip surgeries.In this study the investigators are comparing continuous S-FICB with continuous epidural analgesia after total hip arthroplasty surgeries with the primary aim to assess efficacy of post-operative analgesia, and secondary aim to assess rehabilitation indices, side effects and radiological pattern of local anaesthetic distribution after S-FICB.

Official Title
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Comparison Of Continuous Epidural Analgesia And Ultrasound Guided Continuous Supra-Inguinal Fascia Iliaca Compartment Block After Total Hip Replacement Surgery

Conditions
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Postoperative Pain

Intervention / Treatment
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* Procedure: continuous epidural analgesia
* Procedure: supra-inguinal fascia iliaca compartment block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: orthopaedic patients, American Society of Anesthesiologists (ASA) physical status I-III, scheduled to undergo unilateral total hip replacement surgery via lateral approach Exclusion Criteria: 1- History of neurological/neuromuscular, psychiatric disease, dementia preventing proper comprehension. 2- Patients younger than 18 years or older than 80 years. 3- Patients with Body Mass Index (BMI) <18.5 or >30 kg/m2. 4- Coagulation disturbances (INR>1.4, platelet count<100 000). 5- History of opioid dependence (opioid use within the last 4 weeks). 6- History of allergies to study medications. 7- Other contraindications to neuraxial blockade (e.g., patient refusal, local/systemic sepsis, low fixed cardiac output). 8- Contraindications to continuous fascia iliaca compartment block (e.g., infection overlying the injection site or previous femoro-popliteal bypass surgery).

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: continuous epidural analgesia<br>continuous lumbar epidural catheter inserted preoperatively before induction of general anaesthesia | Procedure: continuous epidural analgesia<br>* injection of local anaesthetic into epidural space<br>* Other names: continuous epidural anaesthesia;|
| Active Comparator: continuous supra-inguinal fascia iliaca compartment block<br>ultrasound guided supra-inguinal FICB with insertion of catheter for continuous infusion before induction of general anaesthesia. | Procedure: supra-inguinal fascia iliaca compartment block<br>* ultrasound guided injection of local anaesthetic into fascia iliaca compartment<br>* Other names: Supra-inguinal FICB;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative analgesia after THA surgery | visual analogue scale (VAS) scores for pain assessment at rest and movements and morphine consumption | 36 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| radiological pattern of local anaesthetic distribution in S-FICB group | imaging of pelvis using x-rays c arm machine | 30 minutes after local anaesthetic injection | 
| success of rehabilitation | rehabilitation indices achievement after THA | 36 hours |