Effect of Quadro-Iliac Plane Block on Recovery After Total Hip Arthroplasty

Effect of Quadro-Iliac Plane Block on Quality of Recovery After Total Hip Arthroplasty: A Prospective, Randomized, Controlled, Double-Blind, Multicenter Study

Total hip arthroplasty is a widely performed surgical procedure in the elderly population, aiming to relieve hip joint pain and restore function. Total hip arthroplasty is among the most critical surgical procedures in terms of morbidity and mortality within this demographic. To mitigate opioid-related adverse effects in this patient group, novel analgesic methods are needed. Regional anesthesia techniques used for postoperative pain management include epidural analgesia, lumbar plexus block, fascia iliaca block, femoral and obturator nerve blocks, and sacral erector spinae plane block. However, these procedures may result in complications such as epidural hematoma, postoperative headache, prolonged motor block, and extended hospital stay.

Study Overview

• Status: Completed
• Conditions: Postoperative Pain
• Intervention / Treatment: Other: Quadro iliac plane block; Other: Control group

Detailed Description

Total hip arthroplasty is a widely performed surgical procedure in the elderly population, aiming to relieve hip joint pain and restore function. Total hip arthroplasty is among the most critical surgical procedures in terms of morbidity and mortality within this demographic. To mitigate opioid-related adverse effects in this patient group, novel analgesic methods are needed. Regional anesthesia techniques used for postoperative pain management include epidural analgesia, lumbar plexus block, fascia iliaca block, femoral and obturator nerve blocks, and sacral erector spinae plane block. However, these procedures may result in complications such as epidural hematoma, postoperative headache, prolonged motor block, and extended hospital stay.

Recently, Tulgar et al. introduced a novel fascial plane block called the "quadro-iliac plane block". This block is performed in the quadro-iliac plane, located between the inner surface of the iliac crest and the posterior surface of the quadratus lumborum muscle. In their study, Tulgar et al. bilaterally injected 40 mL of methylene blue into the quadro-iliac plane, observing widespread dye distribution along the posterior and anterior surfaces of the quadratus lumborum muscle, transversalis fascia, ilioinguinal, iliohypogastric, subcostal, and genitofemoral nerves, as well as the lumbar plexus. Based on these findings, quadro-iliac plane block has been proposed as a potentially effective technique for managing acute or chronic pain in the lumbosacral, abdominal, and hip regions. However, apart from a few case reports involving lumbar spine surgery and kidney transplantation, evidence regarding the efficacy of quadro-iliac plane block remains limited.

• Study Type: Interventional
• Enrollment (Actual): 64
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Karatay
    • Konya, Karatay, Turkey, 42020
      • Konya City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Unilateral THA.
• Spinal anesthesia.
• Age 18-85 years.
• ASA classification I-IV.

Exclusion Criteria:

• Patients who declined consent.
• Contraindications to regional anesthesia.
• Coagulation disorders.
• Infections at the block site.
• Emergency surgeries.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: control group; IV paracetamol (1 g, 3×1) and IV dexketoprofen (50 mg, 2×1)	Other: Quadro iliac plane block; 40 mL of 0.25% bupivacaine
Active Comparator: Quadro iliac plane block; 40 mL of 0.25% bupivacaine	Other: Control group; IV paracetamol (1 g, 3×1) and IV dexketoprofen (50 mg, 2×1)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Quality of Recovery-15	The primary outcome was the Quality of Recovery-15 score at 24 hours postoperatively. QoR-15 scores range from 0 to 150, with higher scores indicating better recovery quality.	24 hours

Collaborators and Investigators

• Sponsor: Konya City Hospital

Study record dates

Study Major Dates

• Study Start (Actual): March 11, 2025
• Primary Completion (Actual): April 25, 2025
• Study Completion (Actual): April 25, 2025

Study Registration Dates

• First Submitted: March 5, 2025
• First Submitted That Met QC Criteria: March 5, 2025
• First Posted (Actual): March 11, 2025

Study Record Updates

• Last Update Posted (Actual): April 27, 2025
• Last Update Submitted That Met QC Criteria: April 25, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Pain, Postoperative
• Other Study ID Numbers: Quadro-Iliac Block Hip

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No