Quadratus Lumborum Type 2 as Chronic Hip Pain Treatment

The main objective of the study is to assess whether the performance of type 2 quadratus lumborum block produces an improvement in the quality of life of the patient with osteoarthritis of the hip.

Study Overview

• Status: Completed
• Conditions: Ultrasound Therapy; Complications; Hip Arthropathy; Chronic Hip Pain
• Intervention / Treatment: Drug: levobupivacaine; Device: ultrasound device

Detailed Description

The quadratus lumborum block is an interfascial block of the posterior wall of the abdomen, initially described for the management of postoperative pain in abdominal surgery due to its suggested effect on the T7-11 roots. The analgesic efficacy of type 1 quadratus lumborum block (QL1) in hip surgery was subsequently published. Regarding chronic pain, QL2 has been successfully performed in posttherniorrhaphy pain or pancreatic cancer.

This quadratus lumborum type 2 or posterior, is performed in the patients with hip joint based on the innervation of the hip and taking the role of thoraco-lumbar fascia in the analgesia of these patients as a reference. The good results obtained in the first 5 patients have led us to evaluate whether this blockade can indeed be an analgesic alternative in patients with coxarthrosis.

• Study Type: Observational
• Enrollment (Actual): 200

Contacts and Locations

Study Locations

• Spain
  • Castilla Y León
    • Valladolid, Castilla Y León, Spain, 47008
      • María Teresa Fernandez

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

patient with coxalgia

Description

Inclusion Criteria:

• Sign informed consent (Annex 2)
• Age 18-85 years
• Cartilage injury (coxarthrosis) hip
• Illness <1 year of evolution
• Patients with pain after treatment with physical therapy, exercises, NSAIDs.
• EVN> 5

Exclusion Criteria:

• Refusal of the patient
• Allergy to the drugs used
• Contraindication for performing the technique
• Intraarticular treatment in the previous 3 months
• Pregnancy

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
quadratus lumborum; analgesic technique. The evaluation of the patient will consist of 2 stages. The first of these will consist of the evaluation consultation (clinical history, EVN evaluation, WOMAC) and initial treatment (QL2 block). In the second stage, the patient will be followed up with interviews at 3 weeks, 3 and 6 months.	Drug: levobupivacaine; local anesthetic; Other Names: chirocane; Device: ultrasound device; scream
Control; Current analgesia , no QL block apply

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
relieve chronic hip pain	The main objective of the study is to assess whether the performance of type 2 lumbar .square block produces an improvement in the quality of life of the patient with osteoarthritis of the hip. The evaluation of the patient will consist of 2 stages. The first of these will consist of the evaluation consultation evaluation with verbal numeric scale (VNS: 0 no dolor-10 the worst pain imaginable ) if patients improve their quality of pain	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
rate of adverse effects of the block	find if there is complications (hematome, kidney punction...)	3 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
relieve chronic pain at 6 month	the main objective was to asses how long was the effect of the analgesia	6 months

Collaborators and Investigators

• Sponsor: Hospital Medina del Campo
• Collaborators: Hospital Universitaio Getafe; Hospital Rio Hortega
• Investigators: Study Chair: Maria Teresa Fernandez, Hospital Medina del Campo

Publications and helpful links

General Publications

• Adhikary SD, Short AJ, El-Boghdadly K, Abdelmalak MJ, Chin KJ. Transmuscular quadratus lumborum versus lumbar plexus block for total hip arthroplasty: A retrospective propensity score matched cohort study. J Anaesthesiol Clin Pharmacol. 2018 Jul-Sep;34(3):372-378. doi: 10.4103/joacp.JOACP_335_17.
• Adhikary SD, El-Boghdadly K, Nasralah Z, Sarwani N, Nixon AM, Chin KJ. A radiologic and anatomic assessment of injectate spread following transmuscular quadratus lumborum block in cadavers. Anaesthesia. 2017 Jan;72(1):73-79. doi: 10.1111/anae.13647. Epub 2016 Oct 12.
• Fernandez Martin MT, Lopez Alvarez S, Ortigosa Solorzano E. Quadratus lumborum block. New approach for a chronic hip pain. Cases report. Rev Esp Anestesiol Reanim (Engl Ed). 2020 Jan;67(1):44-48. doi: 10.1016/j.redar.2019.10.001. Epub 2019 Nov 22. English, Spanish.
• Fernandez MT, Aguirre JA, Lopez S. Posterior Quadratus Lumborum Block, A Novel Approach to Treat Chronic Hip Pain: A Case Series. A A Pract. 2023 Mar 17;17(3):e01671. doi: 10.1213/XAA.0000000000001671. eCollection 2023 Mar 1.
• Fernandez Martin MT, Ortigosa E, Aguirre JA. Posterior quadratus lumborum block in chronic hip pain, preliminary results from a prospective study. Minerva Anestesiol. 2023 Mar;89(3):231-233. doi: 10.23736/S0375-9393.22.16892-6. Epub 2022 Oct 25. No abstract available.

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2020
• Primary Completion (Actual): September 1, 2022
• Study Completion (Actual): June 1, 2024

Study Registration Dates

• First Submitted: June 10, 2020
• First Submitted That Met QC Criteria: June 17, 2020
• First Posted (Actual): June 18, 2020

Study Record Updates

• Last Update Posted (Actual): October 23, 2024
• Last Update Submitted That Met QC Criteria: October 19, 2024
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Keywords: ultrasound therapy; chronic hip pain
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases; Physiological Effects of Drugs; Peripheral Nervous System Agents; Anesthetics, Local; Anesthetics; Central Nervous System Depressants; Sensory System Agents; Levobupivacaine
• Other Study ID Numbers: PI20-1770 A.4.2/PI 21-PI104

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No