Pain, Postoperative
Conditions
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.
Interventions
PROCEDUREAnterior Quadratus lamborum block
Local anaesthetic will be injected in the fascial plane between psoas major muscle and quadratus lumborum muscle.
Sponsors
Alexandria University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
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.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity assessment | every hour for the first 4 post operative hours and then every 4 hours for the rest of the 24 post operative hours. | Patients will be trained to use visual analogue scale which consists of 10cm line, 0 cm equivalent to no pain and 10 cm denoting the worst imaginable pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total amount of post operative morphine (mg). | any time in the first 24 post operative hours. | Total amount of post operative morphine (mg) used as rescue analgesia and the first time of its request. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction. | every hour in the first 4 post operative hours and then every 4 hours for the rest of the 24 post operative hours. | Patient satisfaction with pain control will be assessed on a four point scale 1.Excellent 2.Good 3.fair 4.poor |
Countries
Egypt
Outcome results
None listed