Clinical trial NCT05228028: Fascia Iliaca Compartment Block Versus Quadratus Lumborum Block in Total Hip Arthroplasty
Official title: Suprainguinal Fascia Iliaca Compartment Block Versus Anterior Quadratus Lumborum Block for Analgesia After Total Hip Arthroplasty: a Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Nerve Block
Pain, Postoperative
Lead sponsor: Seoul National University Hospital
Sponsor class: OTHER
First posted: 2022-02-08
Enrollment: 80
Sex: ALL
Minimum age (years): 19
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Patients undergoing total hip arthroplasty are randomly assigned to two groups (fascia iliaca compartement block \[FICB\] group or quadratus lumborum block \[QLB\] group). In the FICB group, ultrasound-guided suprainguinal FICB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is performed on the ipsilateral surgical side at the end of surgery. In the QLB group, ultrasound-guided anterior QLB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery. A standardized multimodal analgesic regimen is used for postoperative pain control. The total use of opioids including patient-controlled analgesia and rescue analgesics is compared in both groups for 24 hours after surgery. The amount of opioids used is compared by conversion to oral morphine equivalent dose. Pain score at rest and movement during postoperative 24 hours, time to first request for analgesics, the incidence of side effects, patient satisfaction for pain control at postoperative 24 hours, quality of recovery at postoperative 24 hours, time to discharge readiness, and hospital length of stay are compared.


Eligibility criteria: Inclusion Criteria:

* Adult patients between the ages of 19 and 70 undergoing total hip arthroplasty under spinal anesthesia
* Be able to provide written consent to participate in clinical trials, understand the procedures of this clinical trial, and be able to properly fill out patient-reported questionnaires
* ASA physical status classification 1-2

Exclusion Criteria:

* ASA physical status classification 3-4
* Patients who are contraindicated to nerve blocks (hypersensitivity to local anesthetics, infection at the injection site, etc.)
* Patients with chronic pain and taking pain medications, antidepressants, and anticonvulsants
* Other major medical or psychiatric conditions that will affect response to treatment
* Refusal of intravenous patient-controlled analgesia
* Patients determined to be unsuitable for this clinical trial by the researchers

Primary outcomes:
measure: Total opioids use for 24 hours
timeFrame: Over the first 24 hours after surgery
Secondary outcomes:
measure: Postoperative pain at rest (Numeric rating scale)
timeFrame: At postoperative 4, 8, 12, 16, 20, 24 hours
measure: Postoperative pain with movement (Numeric rating scale)
timeFrame: At postoperative 4, 8, 12, 16, 20, 24 hours
measure: Time to first request for pain medication
timeFrame: From the end of surgery to discharge, an average of 4 days
measure: Incidence of postoperative nausea and vomiting
timeFrame: Over the first 24 hours after surgery
measure: Patient satisfaction score with pain control at 24 hours after surgery
timeFrame: At 24 hours after surgery
measure: Quality of Recovery at 24 hours after surgery
timeFrame: At 24 hours after surgery
measure: Time to discharge readiness
timeFrame: From the end of surgery to discharge, an average of 4 days
measure: Hospital length of stay
timeFrame: From the end of surgery to discharge, an average of 4 days
Other outcomes:
Locations:
city: Seoul
country: Korea, Republic of
facility: Seoul National University Hospital
Study officials:
affiliation: Seoul National University Hospital
name: Seokha Yoo, M.D.
role: PRINCIPAL_INVESTIGATOR
References: