Fascia Iliaca Compartment Block Versus Quadratus Lumborum Block in Total Hip Arthroplasty

Suprainguinal Fascia Iliaca Compartment Block Versus Anterior Quadratus Lumborum Block for Analgesia After Total Hip Arthroplasty: a Randomized Controlled Trial

Patients undergoing total hip arthroplasty are randomly assigned to two groups (fascia iliaca compartement block [FICB] group or quadratus lumborum block [QLB] group). In the FICB group, ultrasound-guided suprainguinal FICB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is performed on the ipsilateral surgical side at the end of surgery. In the QLB group, ultrasound-guided anterior QLB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery. A standardized multimodal analgesic regimen is used for postoperative pain control. The total use of opioids including patient-controlled analgesia and rescue analgesics is compared in both groups for 24 hours after surgery. The amount of opioids used is compared by conversion to oral morphine equivalent dose. Pain score at rest and movement during postoperative 24 hours, time to first request for analgesics, the incidence of side effects, patient satisfaction for pain control at postoperative 24 hours, quality of recovery at postoperative 24 hours, time to discharge readiness, and hospital length of stay are compared.

Study Overview

• Status: Active, not recruiting
• Conditions: Pain, Postoperative; Nerve Block
• Intervention / Treatment: Procedure: fascia iliaca compartement block; Procedure: quadratus lumborum block

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of, 03080
    • Seoul National University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 15 years to 66 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Adult patients between the ages of 19 and 70 undergoing total hip arthroplasty under spinal anesthesia
• Be able to provide written consent to participate in clinical trials, understand the procedures of this clinical trial, and be able to properly fill out patient-reported questionnaires
• ASA physical status classification 1-2

Exclusion Criteria:

• ASA physical status classification 3-4
• Patients who are contraindicated to nerve blocks (hypersensitivity to local anesthetics, infection at the injection site, etc.)
• Patients with chronic pain and taking pain medications, antidepressants, and anticonvulsants
• Other major medical or psychiatric conditions that will affect response to treatment
• Refusal of intravenous patient-controlled analgesia
• Patients determined to be unsuitable for this clinical trial by the researchers

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: fascia iliaca compartement block [FICB] group	Procedure: fascia iliaca compartement block; Ultrasound-guided suprainguinal FICB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery.; Other Names: FICB
Experimental: quadratus lumborum block [QLB] group	Procedure: quadratus lumborum block; Ultrasound-guided anterior QLB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery.; Other Names: QLB

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total opioids use for 24 hours	Total dose of opioids used upto 24 hours after surgery (morphine milligram equivalents)	Over the first 24 hours after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative pain at rest (Numeric rating scale)	Postoperative pain at rest (Numeric rating scale; minimum 0, maximum 10, a higher score means more pain)	At postoperative 4, 8, 12, 16, 20, 24 hours
Postoperative pain with movement (Numeric rating scale)	Postoperative pain with movement (Numeric rating scale; minimum 0, maximum 10, a higher score means more pain)	At postoperative 4, 8, 12, 16, 20, 24 hours
Time to first request for pain medication	Time to first request for pain medication after surgery	From the end of surgery to discharge, an average of 4 days
Incidence of postoperative nausea and vomiting	Incidence of postoperative nausea and vomiting (%)	Over the first 24 hours after surgery
Patient satisfaction score with pain control at 24 hours after surgery	Patient satisfaction score with pain control at 24 hours after surgery (minimum 0, maximum 10, a higher score means higher satisfaction)	At 24 hours after surgery
Quality of Recovery at 24 hours after surgery	Quality of Recovery at 24 hours after surgery assessed by QoR-15 questionnaire	At 24 hours after surgery
Time to discharge readiness	Days of hospitalization after surgery until discharge readiness (defined as satisfying the following three criteria; (1) adequate pain control (numeric rating scale score < 4), (2) no intravenous opioid use in the past 12 hours, and (3) able to walk at least 30 m without time limit)	From the end of surgery to discharge, an average of 4 days
Hospital length of stay	Days of hospitalization after surgery until discharge	From the end of surgery to discharge, an average of 4 days

Collaborators and Investigators

• Sponsor: Seoul National University Hospital
• Investigators: Principal Investigator: Seokha Yoo, M.D., Seoul National University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): March 22, 2022
• Primary Completion (Actual): October 21, 2022
• Study Completion (Anticipated): February 28, 2023

Study Registration Dates

• First Submitted: January 18, 2022
• First Submitted That Met QC Criteria: February 7, 2022
• First Posted (Actual): February 8, 2022

Study Record Updates

• Last Update Posted (Actual): October 26, 2022
• Last Update Submitted That Met QC Criteria: October 25, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Postoperative Complications; Pain; Neurologic Manifestations; Pain, Postoperative
• Other Study ID Numbers: 2112-062-1282

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