Hip Fractures, Lumbar Erector Spinae Plane Block
Conditions
Brief summary
Hip surgery accounts for a high percentage of both emergency and elective surgical procedures in hospitals. Regardless of surgery being prescribed to treat a fracture or coxarthrosis, patients are usually elderly with multiple associated comorbidities. When faced with this patient profile, there is a tendency to undertreat pain for fear of the side effects and pharmacological interactions of conventional analgesic drugs. Ultrasound-guided regional anesthesia applied in orthopedic and trauma surgery has been shown to reduce the doses of opioids and conventional analgesics, to ease deambulation and early recovery, to improve respiratory dynamics and to reduce vein thrombosis and pneumonias. Our study aims to verify whether L-ESP block is effective in the hip and proximal femur surgeries and allows to lower the dosage of opioids in these patients.
Interventions
DRUGLumbar Erector Spinae Plane Block. L bupivacaína 0.25%
Ultrasound-guided ESP-L shall be carried out at the L3-14 level with 30 mL of levobupivacaine 0.25%
Sponsors
Hospital Álvaro Cunqueiro
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Caregiver)
Masking description
Pragmatic randomized low interventional single-centre parallel non blinded design with blinded assessment of the objectives.
Intervention model description
Pragmatic single-centre parallel group randomized clinical trial
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Both sexes over 18 years of age having undergone hip surgery * ASA I-III (classification system used by the American Society of Anesthesiologists where I is low anesthetic risk and IV is high risk) * Capacity to comprehend the principles of pain assessment using the VAS visual analogue scale * Previously signed an informed consent.
Exclusion criteria
* Contraindications for the technique and/or the drugs used in this context * Technical inability to perform the block * Severe cognitive impairment or prior mental disabilities described in their medical records * Patients already included in other clinical trials.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To compare the analgesic effectiveness and safety of lumbar ESP block versus absence of block after hip and proximal femur surgeries by means of the VAS scale with pain reduction of at least 1 point in the first two hours after surgery. | 2 hours after surgery | Collect data on post-surgery pain using the Visual Analogue Scale (VAS).The VAS scale ranges from 0 to 10, with 0 being no pain and 10 being maximum pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Compare the analgesic postoperative needs after performing L-ESP block versus a control group of patients having undergone hip or proximal femur surgeries and the postoperative consumption of opioids in both groups | 12 hours postoperative | Consumption of morphine (mg) |
| Percentage of patients with technical ease to perform the esp-l block | 48 hours postoperative | We will define the technical ease of the esp-l block from 1 to 3. 1 being good and when we are able to clearly distinguish anatomical structures in order to carry out the locoregional analgesia, 2 would be equivalent to regular, when these are sensed but not clearly defined structures and bad when we are not able to distinguish any anatomical structure that allows us to carry out the block. |
| Patient satisfaction survey on pain management | 48 hours postoperative | We will classify patients into two groups according to their satisfaction with pain management in the postoperative period of hip surgery. Being the group of patients who consider themselves satisfied with pain management when it meets their expectations and dissatisfied if the patients are discomforted with it. |
| Describe de side effects of the lumbar ESP block and morphine | 48 hours postoperative | pruritus, nausea, vomiting, erythema, hypotension |
Countries
Spain
Contacts
Primary ContactLaura García Reza
Outcome results
None listed