Clinical trial NCT03502369: Ultrasound Guided Quadratus Lumborum Block for Post Operative Analgesia After Hip Arthroplasty
Official title: Randomized, Controlled, Double Blind Trial of Ultrasound Guided Quadratus Lumborum Block for Post Operative Analgesia After Hip Arthroplasty
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Pain, Postoperative
Lead sponsor: Alexandria University
Sponsor class: OTHER
First posted: 2018-04-18
Enrollment: 90
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Adult 90 orthopaedic patient ASA physical status \|-\|\|\| will be randomly allocated in two groups each one 45 patients, one group will receive the anterior quadratus lumborum block and the other group will not receive the block.
Primary purpose: TREATMENT

Brief summary: The study evaluates the effectiveness of anterior quadratus lumborum block for post operative analgesia after hip arthroplasty. Half of the participants will receive ultrasound guided anterior quadratus lumborum block using 30ml bupivacaine 0.375%, while the other half will not receive the block ( control group).

Detailed description: Sensory innervation of the hip region involves branches of the lumbar plexus and sacral plexus. Effective post operative analgesia can be approached by blocking the lumbar plexus at the level of the quadratus lumborum muscle. Quadratus lumborum block has several approach methods (anterior, lateral, posterior, and intramuscular). Anterior quadratus lumborum block also known as transmuscular QL block or QL3, the local anaesthetic (30ml of bupivacaine 0.375%) is injected between the psoas major muscle (PM) and the quadratus lumborum muscle (QL). Therefore, the anterior quadratus lumborum block may generate analgesia from T10 to L4 covering the sensory innervation of the hip region.

Eligibility criteria: Inclusion Criteria:

* American society of anesthesiologists physical status \|-\|\|\| , scheduled to undergo unilateral hip replacement via lateral approach.

Exclusion Criteria:

* patient refusal.
* History of neurological/neuromuscular, psychiatric, dementia preventing proper comprehension.
* coagulation disorders.
* History of allergy to the study medication.
* Infection overlying the injection site.

Primary outcomes:
measure: Pain intensity assessment
timeFrame: every hour for the first 4 post operative hours and then every 4 hours for the rest of the 24 post operative hours.
Secondary outcomes:
measure: Total amount of post operative morphine (mg).
timeFrame: any time in the first 24 post operative hours.
Other outcomes:
measure: Patient satisfaction.
timeFrame: every hour in the first 4 post operative hours and then every 4 hours for the rest of the 24 post operative hours.
Locations:
city: Alexandria
country: Egypt
facility: Alexandria faculty of medicine
Study officials:
References:
citation: Ueshima H, Otake H, Lin JA. Ultrasound-Guided Quadratus Lumborum Block: An Updated Review of Anatomy and Techniques. Biomed Res Int. 2017;2017:2752876. doi: 10.1155/2017/2752876. Epub 2017 Jan 3.
citation: Sauter AR, Ullensvang K, Niemi G, Lorentzen HT, Bendtsen TF, Borglum J, Pripp AH, Romundstad L. The Shamrock lumbar plexus block: A dose-finding study. Eur J Anaesthesiol. 2015 Nov;32(11):764-70. doi: 10.1097/EJA.0000000000000265.