Analgesia, Pericapsular Nerve Group Block, Supra-Iliac Anterior Quadratus Lumborum Block, Total Hip Arthroplasty
Conditions
Brief summary
This study aims to compare the analgesic efficacy of supra-iliac anterior quadratus lumborum block (SA-QLB) and pericapsular nerve group (PENG) block in patients undergoing total hip arthroplasty (THA).
Detailed description
Total hip arthroplasty (THA) is one of the most common elective orthopedic procedures, performed to restore mobility, alleviate pain and improve quality of life in patients with degenerative hip joint disease. Its rate is projected to further increase with aging of the population worldwide. Pericapsular nerve group (PENG) block is a fascial block targets periarticular sensory branches derived from the femoral, obturator and accessory obturator nerves innervating the anterior hip capsule. The ultrasound-guided quadratus lumborum block (QLB) is a regional anesthetic technique with many described approaches: the lateral QL (QL1) block, the posterior QL (QL2) block, and the anterior QL (transmuscular) block.
Interventions
OTHERSupra-iliac anterior quadratus lumborum block
Patients will receive a supra-iliac anterior quadratus lumborum block (SA-QLB) using 20mL of bupivacaine 0.25%.
OTHERPericapsular nerve group block
Patients will receive an ultrasound-guided pericapsular nerve group (PENG) block 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 75 Years
Healthy volunteers
No
Inclusion criteria
* Age from 18 to 75 years. * Both sexes. * American Society of Anesthesiologists (ASA) classification I-III. * Scheduled for primary elective unilateral total hip arthroplasty (THA) under spinal anesthesia.
Exclusion criteria
* Known allergies to the drugs used. * Infection at the injection site. * Bleeding disorders. * Recognized neuromuscular disorders. * Opioid addiction or dependence. * Contraindications to regional anesthesia or peripheral nerve blockade. * Body mass index (BMI) \> 40 kg/m². * Associated decompensated cardiac, hepatic, respiratory, or renal diseases.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 12 hours postoperatively | Each patient will be instructed about postoperative pain assessment with visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable") |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption | 48 hours postoperatively | Rescue analgesia of morphine will be given as 3 mg bolus if the VAS \> 3 to be repeated after 30 min if pain persists until the visual analog scale (VAS) \< 4. VAS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 12, 24, and 48 h postoperatively. |
| Time to the first rescue analgesia | 48 hours postoperatively | Time to the first request for the rescue analgesia will be recorded from the end of block to first dose of morphine administrated. |
| Time to ambulation | Till the first successful mobilization (Up to 4 hours) | Time to ambulation will be recorded from the end of surgery to the first successful mobilization of the patient, defined as the ability to stand and walk at least 3-5 steps with or without assistance. |
| Length of hospital stay | Till discharge from the hospital (Up to 2 weeks) | Length of hospital stay will be recorded from admission till the discharge from hospital. |
| Incidence of adverse events | 24 hours postoperatively | Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication will be recorded. |
Countries
Egypt
Contacts
CONTACTMohammed S Elsharkawy, MD
Outcome results
None listed