Hip Arthroplasty, Hip Surgery
Conditions
Keywords
regional anesthesia, hip, hip fracture, QIP, hip arthroplasty
Brief summary
The goal of this observational study is to learn about the effectiveness of different locoregional anesthesia techniques, particularly the Quadro-Iliac Plane (QIP) block, in patients undergoing hip surgery, including arthroplasty. The main question it aims to answer is: Does the QIP block improve postoperative recovery and pain control compared to other routinely used locoregional anesthesia techniques in patients undergoing hip surgery? Participants undergoing hip surgery as part of their standard clinical care will receive one of the locoregional anesthesia techniques already in use at the hospital (including QIP block, fascia iliaca block, PENG block, or others, according to anesthesiologist choice). Postoperative outcomes will be collected prospectively, including quality of recovery (QoR-15 at 24 hours), pain scores at rest and during movement at predefined time points up to 48 hours, analgesic consumption, time to first analgesic request, time to mobilization, and occurrence of complications.
Detailed description
This prospective, observational, non-interventional clinical study will evaluate postoperative recovery and analgesic outcomes in adult patients undergoing hip surgery who receive locoregional anesthesia techniques already used in routine clinical practice. The study focuses particularly on the Quadro-Iliac Plane (QIP) block, a recently introduced fascial plane block performed at the posterior-inferior aspect of the quadratus lumborum muscle near its insertion on the iliac crest. The QIP block will be assessed in comparison with other locoregional techniques routinely used for hip surgery, including fascia iliaca block, PENG block, sacral or lumbosacral erector spinae plane block, femoral nerve block, sciatic nerve block, lumbar plexus block, neuraxial anesthesia, or combinations of these techniques. Patients will not be randomized, and the choice of anesthetic and analgesic technique will be made by the attending anesthesiologist according to standard clinical practice. All blocks will be ultrasound-guided and performed under aseptic conditions using approved local anesthetics. Standard perioperative monitoring, spinal anesthesia when appropriate, postoperative multimodal analgesia, and rescue analgesia will be provided according to institutional protocols. The primary endpoint will be postoperative quality of recovery, assessed using the Quality of Recovery-15 score 24 hours after surgery. Secondary outcomes will include postoperative pain scores at rest and during movement at predefined time points up to 48 hours, patient satisfaction, total analgesic consumption, time to first rescue analgesic request, time to first mobilization, nausea and vomiting, antiemetic use, and block-related or postoperative adverse events. Safety monitoring will include immediate complications during block performance, early post-block complications, and delayed neurological symptoms assessed up to 7 days after surgery. The study plans to include at least 40 patients, with a possible sample size of 40-80 cases, and an expected maximum study duration of 18 months.
Interventions
PROCEDUREFascia iliaca block (FIB)
Fascia Iliaca Block
Sponsors
San Giovanni di Dio Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Patients undergoing hip surgery, either elective or for a proximal femoral fracture * Expected postoperative hospital stay ≥ 24 hours * ASA physical status I-III * Neuraxial and/or locoregional anesthesia according to standard clinical practice * Provision of informed consent to participate in the study
Exclusion criteria
* Absence of informed consent * Contraindications to locoregional and/or spinal anesthesia * Allergy to local anesthetic agents * Cognitive impairment preventing reliable assessment of outcomes * Coagulation disorders and/or platelet abnormalities * Antiplatelet or anticoagulant therapy that contraindicates spinal anesthesia * Presence of localized infection or sepsis at the sites to be treated
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quality of Recovery (QoR)-15 score | 24 hours postoperatively | The Quality of Recovery-15 (QoR-15) is a validated patient-reported outcome measure designed to assess the quality of postoperative recovery across multiple dimensions of physical and psychological well-being. The questionnaire consists of 15 items, each scored on an 11-point numerical scale, resulting in a total score ranging from: Minimum score: 0 → extremely poor quality of recovery Maximum score: 150 → excellent quality of recovery Higher QoR-15 scores indicate a better postoperative recovery experience. The questionnaire evaluates five key domains: Pain Physical comfort Physical independence Psychological support Emotional state |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain | 0-2-4-6-8-12-24-48 hours after surgery | The Numerical Rating Scale (NRS) is a validated and widely used tool for the assessment of pain intensity in clinical practice and perioperative research. Patients are asked to rate their pain on a numerical scale ranging from: 0 → no pain 10 → worst pain imaginable |
| First analgesia request | up to 48 hours | Duration of analgesia |
| First mobilization | 24 hours postoperatively | First mobilization of the patient after surgery |
| Complications | up to 48 hours | Toxicity, PONV, others |
Countries
Italy
Contacts
CONTACTTommaso Sorrentino, MD
Outcome results
None listed