Clinical trial NCT06688136: QLESP Block Versus Periarticular Infiltration for Postoperative Analgesia in Hip Surgery
Official title: Ultrasound-guided Transmuscular Quadratus Lumborum and Modified Erector Spinae Plane Block Versus Periarticular Infiltration for Pain Management After Total Hip Arthroplasty
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Regional Anaesthesia
Lead sponsor: Huazhong University of Science and Technology
Sponsor class: OTHER
First posted: 2024-11-14
Enrollment: 80
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: Local and/or regional analgesia techniques are critical components of an optimal multimodal analgesia technique, as they have been shown to improve pain relief as well as reduce opioid requirements. Optimal pain management technique balances pain relief with concerns about safety and adverse effects associated with analgesic techniques. Periarticular infiltration (PAI) is increasingly included as a component of multimodal analgesia technique for patients undergoing THA, as it provides improved postoperative pain relief with no effects on quadriceps function. Recently, our group has developed a novel transmuscular quadratus lumborum and modified erector spinae plane (QLESP) block, which is characterized by simple operation, high efficiency, and wide dermatomal coverage of sensory block. Therefore, we designed a randomized controlled trial to compare ultrasound-guided QLESP with PAI as a component of non-opioid analgesic regimen in patients undergoing THA via posterior approach. We hypothesized that QLESP would provide superior analgesia when compared with PAI. The primary outcome of the study was postoperative opioid requirements within the initial 24-h postoperative period after THA. The secondary objectives were to compare pain scores, postoperative quadriceps strength, the time to first rescue analgesia, opioid-related adverse effects, time to ambulation, and the time to hospital discharge.


Eligibility criteria: Inclusion Criteria:

1. Age 18-65 yrs
2. American Society of Anesthesiologists classification 1-3
3. Body mass index between 20 and 35 (kg/m2)
4. Undergo elective primary unilateral THA via a posterolateral approach
5. Informed consent

Exclusion Criteria:

1. A known allergy to the drugs being used
2. Pre-existing neuropsychiatric disorders or language barrier
3. Analgesics intake, history of substance abuse
4. Contraindications to peripheral nerve block
5. Acute cerebrovascular disease
6. Severe liver failure

Primary outcomes:
measure: The cumulative opioid consumption
timeFrame: At 24 postoperative hours
Secondary outcomes:
measure: The pain scores determined by the numeric rating scale (NRS, 0-10)
timeFrame: Postoperative 48 hours
measure: Quadriceps strength
timeFrame: Postoperative 48 hours
measure: Postoperative hospital length of stay
timeFrame: Up to 6 weeks
Other outcomes:
Locations:
city: Wuhan
country: China
facility: Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
state: Hubei
Study officials:
affiliation: Wuhan Union Hospital, China
name: Xi Wu
role: PRINCIPAL_INVESTIGATOR
References: