Acute Pain, Opioid Use
Conditions
Brief summary
Arthroscopic hip surgery is being increasingly performed to treat both intraarticular and extraarticular hip diseases. Despite the minimally invasive approach, patients undergoing arthroscopic hip surgery still suffer severe pain due to the complex nature of hip innervation. Postoperative pain reduces patient satisfaction and delay patient recovery and discharge. The efficacy of regional anesthesia techniques in postoperative pain management have been proved in various surgeries. However, it remains controversial whether or not peripheral nerve blocks can significantly improve postoperative analgesia after hip arthroscopy. Several studies have shown that the fascia iliac block cannot improve postoperative analgesia for hip arthroscopy because it blocks only some branches of the lumbar plexus but not the sacral plexus. Circum-Psoas Block (CPB) which has been defined in recent years is able to block the lumbar plexus nerves as well as sacral plexus such as the sciatic, superior gluteal, and inferior gluteal nerves. Therefore, the investigators predict that it can provide effective postoperative analgesia for hip arthroscopy. In this study, the researchers aim to investigate the effectiveness of CPB in hip arthroscopy.
Interventions
PROCEDURECircum-psoas Block
Ultrasound-guided circum-psoas block with 40 mL of treatment drug (Ropivacaine 0.2% \[local anesthetic\]) 30 minutes prior to induction of anesthesia.
PROCEDURESham block
Perform ultrasound scanning without puncture.
Sponsors
The Second Hospital of Shandong University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Primary unilateral ambulatory hip arthroscopy * Age 18 to 70 years * ASA physical status I to III * Ability to follow the protocol.
Exclusion criteria
* Age \<18 or \>70 years of age * BMI above 40 * Contraindications to peripheral nerve blockade * Pregnancy * Chronic pain condition requiring opioid intake at home * Allergy to opioids or local anesthetics * Patient refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain severity at 6 hours postoperatively | 6 hours postoperatively | Postoperative pain assessed with NRS pain score (NRS 0: no pain 10: pain as bad as can be) at 1, 6, 12, 24 hours postoperatively. However, to be more precise in our assessment, the effectiveness of each intervention was defined as a reduction in the pain at 6 hours postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction | at the end of 24 hours postoperatively | Patient satisfaction measured using a numeric rating scale 0 to 10 (0 = unsatisfied; 10 =very satisfied) |
| Postoperative opioid consumption | up to the first 24 hours postoperatively | Cumulative 24-hr postoperative opioid consumption |
| Postoperative nausea and vomiting | up to the first 24 hours postoperatively | Nausea and vomiting intensity score measured by numeric rank score (0:no nausea and no vomiting, 1: have nausea, no vomiting, 2: once vomiting, 3: two or more vomiting). |
| neurologic evaluation | 1, 6, 24 hours postoperatively | The dermatomal coverage of sensory block was evaluated by using a cool roller at 1, 6, 24 hours post-surgery. Motor strength was assessed by the following criteria (0: none; 1: muscle flicker without movement; 2: movement, but not against gravity; 3: movement against gravity; 4: movement against some resistance; 5: normal strength). |
Contacts
Primary ContactNing Li, Doctor
Outcome results
None listed