Ultrasound-Guided Quadro-Iliac Plane Block for Pain Management After Total Hip Arthroplasty

March 26, 2026 updated by: Mursel Ekinci, Bursa City Hospital

Effectiveness of Ultrasound-Guided Quadro-Iliac Plane Block for Pain Management After Total Hip Arthroplasty: A Prospective Randomized Study

This prospective, randomized, double-blind study evaluates the analgesic effectiveness of the ultrasound-guided Quadro-Iliac Plane (QIP) block in patients undergoing primary total hip arthroplasty. The QIP block is a recently described fascial plane block. Patients will be randomized to receive either a QIP block with local anesthetic or a sham block with saline. The primary outcome is 24-hour opioid consumption. Secondary outcomes include motor block, dermatomal sensory assessment, pain scores, rescue analgesic requirement, quality of recovery (QoR-15), and opioid-related side effects.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Total hip arthroplasty is associated with significant postoperative pain. The Quadro-Iliac Plane (QIP) block is a recently described fascial plane block targeting the area where the quadratus lumborum muscle attaches to the iliac crest and may provide more comprehensive analgesia. This study is designed as a prospective, randomized, double-blind clinical trial including patients aged 18-80 years with ASA physical status I-III undergoing elective primary total hip arthroplasty.

Patients will be randomized into two groups. The QIP group will receive an ultrasound-guided QIP block with 40 mL of 0.25% local anesthetic solution containing epinephrine, and the control group will receive a sham block with 40 mL of 0.9% NaCl using the same technique. The primary outcome is postoperative 24-hour opioid consumption. Secondary outcomes include motor block, and dermatomal sensory assessment, pain scores, quality of recovery (QoR-15), rescue analgesic requirement and opioid-related side effects

Study Type

Interventional

Enrollment (Estimated)

100

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • American Society of Anesthesiologists (ASA) classification I-III
  • Age between 18 and 80 years
  • Patients scheduled for elective primary total hip arthroplasty

Exclusion Criteria:

  • Refusal to participate in the study
  • Allergy to local anesthetics or opioids
  • Known or suspected coagulopathy
  • Infection at the injection site
  • History of previous hip surgery
  • Severe cardiovascular disease
  • Liver or kidney failure
  • Pregnancy, suspected pregnancy, or breastfeeding
  • Severe neurological or psychiatric disorder
  • Chronic opioid use

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Quadro-Iliac Plane (QIP) Block
Participants in this arm will receive the standard analgesia protocol used for patients undergoing total hip arthroplasty. In addition to this standard regimen, an ultrasound-guided Quadro-Iliac Plane (QIP) block will be performed in the preoperative period with the patient in the lateral decubitus position. The technique aims to provide postoperative analgesia by achieving sensory blockade in the relevant dermatomal areas.
Procedure: Quadro-Iliac Plane (QIP) Block
An ultrasound-guided Quadro-Iliac Plane block performed in the preoperative period. At the level of the iliac crest, 40 mL of a solution containing 0.25% levobupivacaine and 5 µg/mL epinephrine is injected into the fascial plane between the erector spinae muscle and the quadratus lumborum muscle under aseptic conditions.
Other Names:
  • QIP Block
Placebo Comparator: Sham Block (Control)
Participants in this arm will receive the standard analgesia protocol used for patients undergoing total hip arthroplasty. In addition to this standard regimen, a sham block will be performed using the same ultrasound-guided technique and patient positioning to mimic the block procedure without providing active regional anesthesia.
Procedure: Sham Block
A sham block performed using the same ultrasound-guided technique in the preoperative period. At the level of the iliac crest, 40 mL of 0.9% NaCl is injected into the fascial plane between the erector spinae muscle and the quadratus lumborum muscle under aseptic conditions.
Other Names:
  • Control Block

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative 24-Hour Morphine PCA Consumption
Time Frame: Postoperative 24 hours
Total amount of morphine delivered by the patient-controlled analgesia (PCA) device during the first 24 hours after surgery, recorded in milligrams (mg).
Postoperative 24 hours

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rescue Analgesic Requirement
Time Frame: Postoperative 0-48 hours
Number of patients requiring rescue analgesia (IV meperidine 0.5 mg/kg) and total dose administered when NRS ≥ 4.
Postoperative 0-48 hours
NRS Pain Scores at Rest and Movement
Time Frame: 2, 6, 12, 24, and 48 hours postoperatively
Postoperative pain will be assessed using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst pain imaginable.
2, 6, 12, 24, and 48 hours postoperatively
QoR-15 Recovery Score
Time Frame: QoR-15 Recovery Score will be evaluated at the postoperative 48th hour

The investigators will use the Turkish version of Quality of Recovery (QoR) / QoR-15 questionnaire.

PART A How have you been feeling in the last 24 hours? (0 to 10, where: 0 = none of the time [poor] and 10 = all of the time [excellent])

Able to breathe easily Been able to enjoy food Feeling rested Have had a good sleep Able to look after personal toilet and hygiene unaided Able to communicate Getting support from hospital doctors and nurses Able to return to work or usual home activities Feeling comfortable and in control Having a feeling of general well-being

PART B Have you had any of the following in the last 24 hours? (10 to 0, where: 10 = none of the time [excellent] and 0 = all of the time [poor])

Moderate pain Severe pain Nausea or vomiting Feeling worried or anxious Feeling sad or depressed

[Total score range: 0-150 points]
QoR-15 Recovery Score will be evaluated at the postoperative 48th hour
Lower Extremity Muscle Strength Score
Time Frame: Postoperative 6th and 12th hours

Postoperative lower extremity muscle strength will be assessed at the 6th postoperative hour using a 0-5 grading scale, where 0 indicates no muscle contraction and 5 indicates normal strength.

The scale is defined as follows:

0 = no muscle contraction

  1. = muscle contraction present without joint movement
  2. = movement without overcoming gravity
  3. = movement against gravity without resistance
  4. = movement against partial resistance
  5. = movement against full resistance (normal strength)
Postoperative 6th and 12th hours
Opioid-Related Side Effects
Time Frame: Postoperative 0-48 hours

Opioid-related side effects will be assessed postoperatively

Other opioid-related side effects, including pruritus, constipation, and somnolence, will be recorded as present or absent.
Postoperative 0-48 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Bursa City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 16, 2026

Primary Completion (Estimated)

February 15, 2027

Study Completion (Estimated)

March 15, 2027

Study Registration Dates

First Submitted

February 7, 2026

First Submitted That Met QC Criteria

February 7, 2026

First Posted (Actual)

February 13, 2026

Study Record Updates

Last Update Posted (Actual)

March 27, 2026

Last Update Submitted That Met QC Criteria

March 26, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Bursa City Hospital 14

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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