Clinical trial NCT04266236: LPB Combined with QLB Using Single-needle Technique (LPQLB-SNT) for Hip Arthroplasty
Official title: Ultrasound-guided Lumbar Plexus Combined with Quadratus Lumborum Block Using Single-needle Technique with Shamrock Method for Hip Arthroplasty
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hip Osteoarthritis
Anesthesia, Local
Hip Fractures
Osteonecrosis of Femoral Head
Keywords: lumbar plexus block
quadratus lumorum block
total hip arthroplasty
single-needle
shamrock approach
Lead sponsor: Shanghai 6th People's Hospital
Sponsor class: OTHER
First posted: 2020-02-12
Enrollment: 84
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Total hip arthroplasty (THA) is one of the most successful orthopedic procedures to effectively relieve pain and restore function in patients with hip osteoarthritis, osteonecrosis of femoral head and hip fracture.The Lumbar Plexus Block (LPB) is currently used as the standard regional anesthesia technique to provide postoperative pain management after THA. The lumbar plexus (LP) originates from T12 to L5. In general, multiple-needle nerve blockade procedure is needed to block different branches of LP. Therefore, we need more time to finish the regional anethesia procedure and it's not easy for an inexperienced anesthesiologist to master the technique absolutely. In addition, multiple injections will increase the discomfort of the patients. We aim to investigate the effects of lumbar plexus combined with quadratus lumborum block using single-needle technique with Shamrock method as an alternative regional anesthesia.


Eligibility criteria: Inclusion Criteria:

1. Body mass index (BMI) between 18.5 and 30kg/m2 and the weight ≥50kg
2. American Society of Anesthesiologists (ASA) classification I-II
3. Postero-lateral operative incision approach unilateral hip arthroplasty
4. Aged 18-75

Exclusion Criteria:

1. Patient refusal
2. Patients with coagulopathy or on therapeutic anticoagulation
3. Pregnancy
4. Multiple trauma
5. Hypersensitivity or allergy to ropivacaine
6. History of ankylosing spondylitis or spinal surgery
7. Lower extremity neuropathy
8. Unable to communicate

Primary outcomes:
measure: sensory block assessment
timeFrame: 30 minutes after nerve block procedure
Secondary outcomes:
measure: postoperative static pain at timepoint 1
timeFrame: at 30mins after the patient recover from general anesthesia
measure: postoperative static pain at timepoint 2
timeFrame: at 6 hours after surgery
measure: postoperative static pain at timepoint 3
timeFrame: at 12 hours after surgery
measure: postoperative static pain at timepoint 4
timeFrame: at 24 hours after surgery
measure: Performance time of block
timeFrame: During nerve block procedure
measure: intraoperative sufentanil dosage
timeFrame: during the operation
measure: Incidence of block related adverse events
timeFrame: within 24hours after nerve block procedure
measure: Cumulative doses of intraoperative vasoactive medications
timeFrame: during the operation
Other outcomes:
Locations:
city: Shanghai
country: China
facility: Shanghai Jiao Tong University Affiliated Sixth People's Hospital
state: Shanghai
Study officials:
References: