Clinical trial NCT04438265: Quadratus Lumborum Type 2 as Chronic Hip Pain Treatment
Official title: Quadratus Lumborum Type 2 as Chronic Hip Pain Treatment
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Hip Arthropathy
Chronic Hip Pain
Ultrasound Therapy; Complications
Keywords: chronic hip pain
ultrasound therapy
Lead sponsor: Hospital Medina del Campo
Sponsor class: OTHER
Collaborators: name: Hospital Universitaio Getafe
name: Hospital Rio Hortega
First posted: 2020-06-18
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: patient with coxalgia

Brief summary: The main objective of the study is to assess whether the performance of type 2 quadratus lumborum block produces an improvement in the quality of life of the patient with osteoarthritis of the hip.

Detailed description: The quadratus lumborum block is an interfascial block of the posterior wall of the abdomen, initially described for the management of postoperative pain in abdominal surgery due to its suggested effect on the T7-11 roots. The analgesic efficacy of type 1 quadratus lumborum block (QL1) in hip surgery was subsequently published. Regarding chronic pain, QL2 has been successfully performed in posttherniorrhaphy pain or pancreatic cancer.

This quadratus lumborum type 2 or posterior, is performed in the patients with hip joint based on the innervation of the hip and taking the role of thoraco-lumbar fascia in the analgesia of these patients as a reference. The good results obtained in the first 5 patients have led us to evaluate whether this blockade can indeed be an analgesic alternative in patients with coxarthrosis.

Eligibility criteria: Inclusion Criteria:

* Sign informed consent (Annex 2)
* Age 18-85 years
* Cartilage injury (coxarthrosis) hip
* Illness \<1 year of evolution
* Patients with pain after treatment with physical therapy, exercises, NSAIDs.
* EVN\> 5

Exclusion Criteria:

* Refusal of the patient
* Allergy to the drugs used
* Contraindication for performing the technique
* Intraarticular treatment in the previous 3 months
* Pregnancy

Primary outcomes:
measure: relieve chronic hip pain
timeFrame: 3 months
Secondary outcomes:
measure: rate of adverse effects of the block
timeFrame: 3 months
Other outcomes:
measure: relieve chronic pain at 6 month
timeFrame: 6 months
Locations:
city: Valladolid
country: Spain
facility: María Teresa Fernandez
state: Castilla Y León
Study officials:
affiliation: Hospital Medina del Campo
name: Maria Teresa Fernandez
role: STUDY_CHAIR
References:
citation: Adhikary SD, Short AJ, El-Boghdadly K, Abdelmalak MJ, Chin KJ. Transmuscular quadratus lumborum versus lumbar plexus block for total hip arthroplasty: A retrospective propensity score matched cohort study. J Anaesthesiol Clin Pharmacol. 2018 Jul-Sep;34(3):372-378. doi: 10.4103/joacp.JOACP_335_17.
citation: Adhikary SD, El-Boghdadly K, Nasralah Z, Sarwani N, Nixon AM, Chin KJ. A radiologic and anatomic assessment of injectate spread following transmuscular quadratus lumborum block in cadavers. Anaesthesia. 2017 Jan;72(1):73-79. doi: 10.1111/anae.13647. Epub 2016 Oct 12.
citation: Fernandez Martin MT, Lopez Alvarez S, Ortigosa Solorzano E. Quadratus lumborum block. New approach for a chronic hip pain. Cases report. Rev Esp Anestesiol Reanim (Engl Ed). 2020 Jan;67(1):44-48. doi: 10.1016/j.redar.2019.10.001. Epub 2019 Nov 22. English, Spanish.
citation: Fernandez MT, Aguirre JA, Lopez S. Posterior Quadratus Lumborum Block, A Novel Approach to Treat Chronic Hip Pain: A Case Series. A A Pract. 2023 Mar 17;17(3):e01671. doi: 10.1213/XAA.0000000000001671. eCollection 2023 Mar 1.
citation: Fernandez Martin MT, Ortigosa E, Aguirre JA. Posterior quadratus lumborum block in chronic hip pain, preliminary results from a prospective study. Minerva Anestesiol. 2023 Mar;89(3):231-233. doi: 10.23736/S0375-9393.22.16892-6. Epub 2022 Oct 25. No abstract available.