Analgesic Efficacy of Quadro-Iliac Plane Block Versus Erector Spinae Plane in Total Hip Arthroplasty

Analgesic Efficacy of Quadro-Iliac Plane Block Versus Erector Spinae Plane in Total Hip Arthroplasty: A Randomized Non-Inferiority Trial

This study aims to compare the Quadro-Iliac Plane Block versus Erector Spinae Plane Block after total hip arthroplasty.

Study Overview

• Status: Recruiting
• Conditions: Analgesic Efficacy; Erector Spinae Plane Block; Total Hip Arthroplasty; Quadro-Iliac Plane Block
• Intervention / Treatment: Other: Quadro-iliac plane block; Other: Erector spinae plane block

Detailed Description

Total hip arthroplasty (THA) is frequently utilized in elderly patients to address hip pain and restore joint function. Effective postoperative pain management is critical; however, the use of opioids is associated with a range of adverse effects, including nausea, vomiting, pruritus, constipation, respiratory depression, and the risk of dependence.

Quadro-iliac plane block (QIPB) has been introduced, combining elements of both posterior and anterior QLB approaches.

Erector Spinae Plane Block (ESPB) was initially described as an analgesic approach for managing thoracic neuropathic pain. This innovative fascial block technique enables sensory blockade across multiple abdominal and thoracic wall segments.

• Study Type: Interventional
• Enrollment (Estimated): 76
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Mohammed S Elsharkawy, MD; Phone Number: 00201148207870; Email: mselsharkawy@med.tanta.edu.eg

Study Locations

• Egypt
  • El-Gharbia
    • Tanta, El-Gharbia, Egypt, 31527
      • Recruiting
      • Tanta university
      • Contact: Mohammed S Elsharkawy, MD; Phone Number: 00201148207870; Email: mselsharkawy@med.tanta.edu.eg

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age ≥ 18 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-III.
• Undergoing total hip arthroplasty (THA) under spinal anesthesia.

Exclusion Criteria:

• History of allergies to local anesthetics.
• Opioid dependency.
• Body mass index (BMI) > 35 kg/m2.
• Cognitive impairment.
• Bleeding or coagulation disorders.
• Psychiatric and neurological disorder.
• Local infection at the site of injection.
• Severe heart, lung, liver, and renal dysfunction.
• Emergency surgery.

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: QIPB group; Patients will receive ipsilateral Quadro-iliac plane block (QIPB) using 20ml of bupivacaine 0.25%.	Other: Quadro-iliac plane block; Patients will receive ipsilateral Quadro-iliac plane block (QIPB) using 20ml of bupivacaine 0.25%.
Experimental: ESPB group; Patients will receive ipsilateral erector spinae plane block (ESPB) using 20ml of bupivacaine 0.25%.	Other: Erector spinae plane block; Patients will receive ipsilateral erector spinae plane block (ESPB) using 20ml of bupivacaine 0.25%.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to the first rescue analgesia	Time to the first request for the rescue analgesia will be recorded from the end of surgery to first dose of morphine administrated.	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total morphine consumption	Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) > 3 to be repeated after 30 min if pain persists until the NRS < 4.	24 hours postoperatively
Degree of pain	Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 8, 12, 18, and 24 h postoperatively.	24 hours postoperatively
Quality of recovery	The quality of recovery (QoR-15) score, will be assessed 24 hours postoperatively. This tool consists of 15 questions, each scored on a 10-point scale, yielding a maximum of 150. It encompasses five domains; physical comfort (questions 1-4, 13), emotional state (questions 9, 10, 14, 15), psychological support (questions 6, 7), physical independence (questions 5, 8), and pain (questions 11, 12	24 hours postoperatively
Incidence of adverse events	Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, or any other complication will be recorded.	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Tanta University

Study record dates

Study Major Dates

• Study Start (Actual): April 18, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: April 11, 2026
• First Submitted That Met QC Criteria: April 11, 2026
• First Posted (Actual): April 17, 2026

Study Record Updates

• Last Update Posted (Actual): April 21, 2026
• Last Update Submitted That Met QC Criteria: April 18, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 36264PR131011044/3/26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

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