Compare Epidural vs. Lumbar Plexus Analgesia After Hip Arthroplasty

Compare Effectiveness of Epidural vs. Lumbar Plexus Blocks in Total Hip Arthroplasty (THA) Patients Using Multimodal Pain Control

The goal of this retrospective chart review is to evaluate if the implementation of lumbar plexus block placement for postoperative pain have improved conditions in the postoperative period for patients undergoing total hip arthroplasty when compared to the placement of epidurals for postoperative pain management.

Study Overview

• Status: Completed
• Conditions: Arthropathy of Hip

Detailed Description

Primary outcome: 48 hour opiate consumption in patients following THA. ' Secondary outcome: Time to first ambulation, assistance needed with ambulation, opiate and regional related side effects, time to discharge orders.

• Study Type: Observational
• Enrollment (Actual): 116

Contacts and Locations

Study Locations

• United States
  • South Carolina
    • Charleston, South Carolina, United States, 29425
      • Medical University of South Carolina

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The study team will identify subject by the Primary Diagnosis of THA, (identified by CPT code 27130) and 2) either a) Epidural (CPT code 62319) or b) Lumbar plexus peripheral nerve block (CPT 62311 or 64449) with the administration of multimodal medication.

Description

Inclusion Criteria:

• 18 years and older

• Diagnosis of:

  1. Primary THA, (identified by CPT code 27130)
  2. Either a) Epidural (CPT code 62319) or b) Lumbar plexus peripheral nerve block (CPT 62311 or 64449)
• Perioperative multimodal medication
• Hospitalized from July 1, 2012 to December 17, 2014.

Exclusion Criteria:

• THA Revision
• ICU admission postoperatively
• History of dementia

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Lumbar Epidural; Patients received a lumbar epidural preoperatively for postoperative pain management. Epidural infusions of ropivacaine 0.2% were initiated intraoperatively, administered until the morning of postoperative day 1, and titrated to patient comfort.
Lumbar plexus; Patients received a preoperative lumbar plexus nerve block (20 ml, ropivacaine 0.5%) for postoperative pain management.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Opiate Consumption	Cumulative opiate consumption in intravenous (IV) morphine mg equivalents (MME)	48 hours postoperative

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time of First Ambulation	Time of first ambulation relative to anesthesia end time (hours)	48 hours

Collaborators and Investigators

• Sponsor: Medical University of South Carolina

Study record dates

Study Major Dates

• Study Start: December 1, 2014
• Primary Completion (Actual): June 1, 2015
• Study Completion (Actual): July 1, 2015

Study Registration Dates

• First Submitted: July 2, 2015
• First Submitted That Met QC Criteria: July 8, 2015
• First Posted (Estimate): July 9, 2015

Study Record Updates

• Last Update Posted (Actual): March 22, 2019
• Last Update Submitted That Met QC Criteria: December 19, 2018
• Last Verified: June 1, 2018

More Information

Terms related to this study

• Keywords: Nerve Block; Pain, Postoperative; Anesthesia, Epidural
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases
• Other Study ID Numbers: Pro00040998