Analgesic Efficacy, Quadro-Iliac Plane Block, Erector Spinae Plane Block, Total Hip Arthroplasty
Conditions
Brief summary
This study aims to compare the Quadro-Iliac Plane Block versus Erector Spinae Plane Block after total hip arthroplasty.
Detailed description
Total hip arthroplasty (THA) is frequently utilized in elderly patients to address hip pain and restore joint function. Effective postoperative pain management is critical; however, the use of opioids is associated with a range of adverse effects, including nausea, vomiting, pruritus, constipation, respiratory depression, and the risk of dependence. Quadro-iliac plane block (QIPB) has been introduced, combining elements of both posterior and anterior QLB approaches. Erector Spinae Plane Block (ESPB) was initially described as an analgesic approach for managing thoracic neuropathic pain. This innovative fascial block technique enables sensory blockade across multiple abdominal and thoracic wall segments.
Interventions
Patients will receive ipsilateral Quadro-iliac plane block (QIPB) using 20ml of bupivacaine 0.25%.
OTHERErector spinae plane block
Patients will receive ipsilateral erector spinae plane block (ESPB) using 20ml of bupivacaine 0.25%.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years. * Both sexes. * American Society of Anesthesiology (ASA) physical status I-III. * Undergoing total hip arthroplasty (THA) under spinal anesthesia.
Exclusion criteria
* History of allergies to local anesthetics. * Opioid dependency. * Body mass index (BMI) \> 35 kg/m2. * Cognitive impairment. * Bleeding or coagulation disorders. * Psychiatric and neurological disorder. * Local infection at the site of injection. * Severe heart, lung, liver, and renal dysfunction. * Emergency surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to the first rescue analgesia | 24 hours postoperatively | Time to the first request for the rescue analgesia will be recorded from the end of surgery to first dose of morphine administrated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption | 24 hours postoperatively | Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4. |
| Degree of pain | 24 hours postoperatively | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 8, 12, 18, and 24 h postoperatively. |
| Quality of recovery | 24 hours postoperatively | The quality of recovery (QoR-15) score, will be assessed 24 hours postoperatively. This tool consists of 15 questions, each scored on a 10-point scale, yielding a maximum of 150. It encompasses five domains; physical comfort (questions 1-4, 13), emotional state (questions 9, 10, 14, 15), psychological support (questions 6, 7), physical independence (questions 5, 8), and pain (questions 11, 12 |
| Incidence of adverse events | 24 hours postoperatively | Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, or any other complication will be recorded. |
Countries
Egypt
Contacts
CONTACTMohammed S Elsharkawy, MD
Outcome results
None listed