The Quadro-Iliac Plane (QIP) Block in Hip Arthroplasty (QIP in hip)

The Effectiveness of the "Quadro-Iliac Plane Block" in Hip Arthroplasty: A Prospective Observational Clinical Study

The goal of this observational study is to learn about the effectiveness of different locoregional anesthesia techniques, particularly the Quadro-Iliac Plane (QIP) block, in patients undergoing total hip arthroplasty. The main question it aims to answer is:

Does the QIP block improve postoperative recovery and pain control compared to other routinely used locoregional anesthesia techniques in patients undergoing hip replacement surgery?

Participants undergoing hip arthroplasty as part of their standard clinical care will receive one of the locoregional anesthesia techniques already in use at the hospital (including QIP block, fascia iliaca block, PENG block, or others, according to anesthesiologist choice). Postoperative outcomes will be collected prospectively, including quality of recovery (QoR-15 at 24 hours), pain scores at rest and during movement at predefined time points up to 48 hours, analgesic consumption, time to first analgesic request, time to mobilization, and occurrence of complications.

Study Overview

• Status: Recruiting
• Conditions: Hip Surgery; Hip Arthroplasty
• Intervention / Treatment: Procedure: Fascia iliaca block (FIB)

Detailed Description

This prospective, observational, non-interventional clinical study will evaluate postoperative recovery and analgesic outcomes in adult patients undergoing hip arthroplasty who receive locoregional anesthesia techniques already used in routine clinical practice.

The study focuses particularly on the Quadro-Iliac Plane (QIP) block, a recently introduced fascial plane block performed at the posterior-inferior aspect of the quadratus lumborum muscle near its insertion on the iliac crest. The QIP block will be assessed in comparison with other locoregional techniques routinely used for hip surgery, including fascia iliaca block, PENG block, sacral or lumbosacral erector spinae plane block, femoral nerve block, sciatic nerve block, lumbar plexus block, neuraxial anesthesia, or combinations of these techniques.

Patients will not be randomized, and the choice of anesthetic and analgesic technique will be made by the attending anesthesiologist according to standard clinical practice. All blocks will be ultrasound-guided and performed under aseptic conditions using approved local anesthetics. Standard perioperative monitoring, spinal anesthesia when appropriate, postoperative multimodal analgesia, and rescue analgesia will be provided according to institutional protocols.

The primary endpoint will be postoperative quality of recovery, assessed using the Quality of Recovery-15 score 24 hours after surgery. Secondary outcomes will include postoperative pain scores at rest and during movement at predefined time points up to 48 hours, patient satisfaction, total analgesic consumption, time to first rescue analgesic request, time to first mobilization, nausea and vomiting, antiemetic use, and block-related or postoperative adverse events. Safety monitoring will include immediate complications during block performance, early post-block complications, and delayed neurological symptoms assessed up to 7 days after surgery.

The study plans to include at least 40 patients, with a possible sample size of 40-80 cases, and an expected maximum study duration of 18 months.

• Study Type: Observational
• Enrollment (Estimated): 80

Contacts and Locations

• Study Contact: Name: Tommaso Sorrentino, MD; Phone Number: +393277038017; Email: dr.sorrentinotommaso@gmail.com

Study Locations

• Italy
  • Crotone, Italy
    • Recruiting
    • Crotone Hospital
    • Contact: Tommaso Sorrentino; Phone Number: +393277038017; Email: dr.sorrentinotommaso@gmail.com

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

Patients undergoing hip arthroplasty surgery, either elective or for a proximal femoral fracture

Description

Inclusion Criteria:

• Age ≥ 18 years
• Patients undergoing hip arthroplasty surgery, either elective or for a proximal femoral fracture
• Expected postoperative hospital stay ≥ 24 hours
• ASA physical status I-III
• Neuraxial and/or locoregional anesthesia according to standard clinical practice
• Provision of informed consent to participate in the study

Exclusion Criteria:

• Absence of informed consent
• Contraindications to locoregional and/or spinal anesthesia
• Allergy to local anesthetic agents
• Cognitive impairment preventing reliable assessment of outcomes
• Coagulation disorders and/or platelet abnormalities
• Antiplatelet or anticoagulant therapy that contraindicates spinal anesthesia
• Presence of localized infection or sepsis at the sites to be treated

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
QIP; Quadro-Iliac Plane Block	Procedure: Fascia iliaca block (FIB); Fascia Iliaca Block

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of Recovery (QoR)-15 score	The Quality of Recovery-15 (QoR-15) is a validated patient-reported outcome measure designed to assess the quality of postoperative recovery across multiple dimensions of physical and psychological well-being. The questionnaire consists of 15 items, each scored on an 11-point numerical scale, resulting in a total score ranging from: Minimum score: 0 → extremely poor quality of recovery Maximum score: 150 → excellent quality of recovery Higher QoR-15 scores indicate a better postoperative recovery experience. The questionnaire evaluates five key domains: Pain Physical comfort Physical independence Psychological support Emotional state	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Complications	Toxicity, PONV, others	up to 48 hours
Postoperative Pain	The Numerical Rating Scale (NRS) is a validated and widely used tool for the assessment of pain intensity in clinical practice and perioperative research. Patients are asked to rate their pain on a numerical scale ranging from: 0 → no pain 10 → worst pain imaginable	0-2-4-6-8-12-24-48 hours after surgery
First analgesia request	Duration of analgesia	up to 48 hours
First mobilization	First mobilization of the patient after surgery	24 hours postoperatively

Collaborators and Investigators

• Sponsor: San Giovanni di Dio Hospital

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): November 1, 2027

Study Registration Dates

• First Submitted: May 4, 2026
• First Submitted That Met QC Criteria: May 12, 2026
• First Posted (Actual): May 15, 2026

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 18, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: hip; hip fracture; regional anesthesia; QIP
• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Fractures, Bone; Femoral Fractures; Hip Injuries; Hip Fractures
• Other Study ID Numbers: QIP_study; No other (Other Identifier: Crotone Hospital)

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