Osteoarthritis of the Hip, Postoperative Pain, Quality of Recovery
Conditions
Brief summary
This prospective randomized controlled trial evaluates the effect of ultrasound-guided unilateral Femoral Rami and Obturator Nerve Trunk (FRONT) block on postoperative quality of recovery in patients undergoing elective total hip arthroplasty.
Detailed description
Total hip arthroplasty (THA) is associated with significant postoperative pain that may impair early recovery. The Femoral Rami and Obturator Nerve Trunk (FRONT) block is a regional anesthesia technique targeting sensory innervation of the anterior hip capsule and may improve postoperative recovery while preserving motor function. This prospective randomized controlled trial aims to evaluate whether the addition of ultrasound-guided unilateral FRONT block to standard multimodal analgesia improves postoperative quality of recovery in patients undergoing THA.
Interventions
PROCEDUREFRONT Block (Femoral Rami and Obturator Nerve Trunk Block)
Ultrasound-guided unilateral FRONT block targeting the femoral rami and obturator nerve trunk will be performed
PROCEDUREStandard Multimodal Analgesia
Standardized postoperative multimodal analgesia including intravenous paracetamol, nonsteroidal anti-inflammatory drugs, and rescue opioid analgesia as required.
Sponsors
Konya Meram State Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessments will be performed by independent researchers blinded to group allocation.
Intervention model description
Participants will be randomized in a 1:1 ratio to receive either an ultrasound-guided unilateral FRONT block plus standard multimodal analgesia or standard multimodal analgesia alone. Outcomes will be compared between the two parallel groups.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Scheduled for total hip arthroplasty under spinal anesthesia * American Society of Anesthesiologists (ASA) physical status I-III * Ability to understand and complete the QoR-15 questionnaire * Provided written informed consent
Exclusion criteria
* Refusal to participate * Contraindication to spinal anesthesia or regional block * Allergy to study medications * Chronic opioid use (daily use for more than 3 months) * Neurological or neuromuscular disorders affecting the lower extremities * Infection at the injection site * Coagulation disorders * Cognitive impairment prevents questionnaire completion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Quality of Recovery (QoR-15 Score) | 24 hours after surgery | Postoperative quality of recovery will be assessed using the validated Quality of Recovery-15 (QoR-15) questionnaire. The total score ranges from 0 to 150, with higher scores indicating better recovery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of Recovery (QoR-15) Score at 48 Hours | 48 hours after surgery | Quality of recovery will be assessed using the validated Quality of Recovery-15 (QoR-15) questionnaire (0-150, higher scores indicate better recovery). |
| Postoperative Pain Intensity | 2, 6, 12, 24, and 48 hours after surgery | Pain intensity will be assessed using an 11-point Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. |
| Total Opioid Consumption | 0-24 hours after surgery | Total postoperative opioid consumption during the first 24 hours will be recorded and converted to intravenous morphine milligram equivalents (MME). |
| Time to First Rescue Analgesia | Within the first 24 hours after surgery | Time from the end of surgery to the first rescue opioid administration will be recorded |
| Time to First Mobilization | Within the first 48 hours after surgery | Time from the end of surgery to first assisted ambulation will be recorded |
| Quadriceps Motor Strength | 0-48 hours after surgery | Quadriceps muscle strength will be evaluated using the Medical Research Council (MRC) scale ranging from 0 (no contraction) to 5 (normal muscle strength). |
Countries
Turkey (Türkiye)
Outcome results
None listed