Erector Spinae vs. Iliopsoas Plane Block for Total Hip Arthroplasty

Study Overview
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Brief Summary
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Effect of iliopsoas plane block and ESPB on pain management, and NLR and PLR following knee arthroplasty

Detailed Description
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Hip arthroplasty is one of the most common orthopedic procedures, especially in elderly patients, due to the deformation of joints. Patients may complain of severe pain due to surgical trauma and prosthesis. Regional anesthesia methods may be performed to reduce the inflammatory response, opioid consumption, and opioid-related side effects. In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasized. However, very few studies have evaluated the effect of various methods of anesthesia on the NLR. This is the first study to investigate the effect of regional anesthesia on the NLR and PLR in patients undergoing hip replacement surgery.

Official Title
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Erector Spinae Plane Block (ESPB) vs. Iliopsoas Plane Block for Pain Management and Stress Response in Patients Undergoing Total Hip Arthroplasty. A Prospective, Randomized Trial.

Conditions
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Hip Osteoarthritis, Hip Arthropathy, Hip Pain Chronic

Intervention / Treatment
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* Drug: Ropivacaine 0.2% Injectable Solution
* Drug: Ropivacaine 0.2% Injectable Solution
* Drug: Control Test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with ASA classification I-III, Aged 20-90 years, Who will be scheduled for hip arthroplasty under spinal anesthesia. Exclusion Criteria: Patients who have a history of bleeding diathesis, Take anticoagulant therapy, have a History of chronic pain before surgery, have Multiple trauma, cannot assess their pain (dementia), have been operated on under general anesthesia, have an infection in the area and do not accept the procedure

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 90 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Iliopsoas Plane Block group<br>ultrasound guided iliopsoas plane block - 20ml 0,2% ropivacaine | Drug: Ropivacaine 0.2% Injectable Solution<br>* ultrasound guided iliopsoas plane block<br>* Other names: iliopsoas plane block;|
| Active Comparator: ESPB group<br>ultrasound guided erector spinae plane block - 20ml 0,2% ropivacaine | Drug: Ropivacaine 0.2% Injectable Solution<br>* ultrasound guided ESPB - L4 level, unilateral<br>* Other names: ESPB;|
| Active Comparator: Control group<br>Only spinal anesthesia - No peripheral nerve block | Drug: Control Test<br>* Only spinal anesthesia<br>* Other names: No peripheral nerve block;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Opioid consumption | Total opiate consumption after surgery | 48 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| first need of opiate | Time after surgery when the patient needs opiate for the first time | 48 hours after procedure | 
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 4 hours after surgery | 
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 8 hours after surgery | 
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 12 hours after surgery | 
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 18 hours after surgery | 
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 24 hours after surgery | 
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 36 hours after surgery | 
| Numerical Rating Scale [range 0:10] | Postoperative pain assessment will be performed using the NRS score (0 = no pain, 10 = the most severe pain felt) | 48 hours after surgery | 
| Neutrophil-to-lymphocyte ratio | Neutrophil-to-lymphocyte ratio | 24 hours after surgery | 
| Neutrophil-to-lymphocyte ratio | Neutrophil-to-lymphocyte ratio | 48 hours after surgery | 
| Platelet-to-lymphocyte ratio | Platelet-to-lymphocyte ratio | 24 hours after surgery | 
| Platelet-to-lymphocyte ratio | Platelet-to-lymphocyte ratio | 48 hours after surgery | 
| Quadriceps muscle strength assessed using medical research council scale [range 0:5] | Quadriceps muscle strength (knee extension and hip adduction) will be evaluated according to the medical research council muscle strength rating | Postoperative 24 hours period |