CPB for Arthroscopic Hip Surgery

Not Applicable

Not yet recruiting

• Conditions: Opioid Use; Acute Pain
• Interventions: Procedure: Sham block; Procedure: Circum-psoas Block

• Registration Number: NCT06337968
• Lead Sponsor: The Second Hospital of Shandong University

Brief Summary

Arthroscopic hip surgery is being increasingly performed to treat both intraarticular and extraarticular hip diseases. Despite the minimally invasive approach, patients undergoing arthroscopic hip surgery still suffer severe pain due to the complex nature of hip innervation. Postoperative pain reduces patient satisfaction and delay patient recovery and discharge. The efficacy of regional anesthesia techniques in postoperative pain management have been proved in various surgeries. However, it remains controversial whether or not peripheral nerve blocks can significantly improve postoperative analgesia after hip arthroscopy.

Several studies have shown that the fascia iliac block cannot improve postoperative analgesia for hip arthroscopy because it blocks only some branches of the lumbar plexus but not the sacral plexus. Circum-Psoas Block (CPB) which has been defined in recent years is able to block the lumbar plexus nerves as well as sacral plexus such as the sciatic, superior gluteal, and inferior gluteal nerves. Therefore, the investigators predict that it can provide effective postoperative analgesia for hip arthroscopy. In this study, the researchers aim to investigate the effectiveness of CPB in hip arthroscopy.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2024-03-24
• Study First Submitted QC: 2024-03-24
• Study First Posted: 2024-03-29
• Status Verified: 2024-11
• Last Update Submitted: 2024-11-21
• Last Update Posted: 2024-11-25
• Study Start: 2024-12-01
• Primary Completion: 2025-12-30
• Study Completion: 2025-12-31

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 74

Inclusion Criteria

• Primary unilateral ambulatory hip arthroscopy
• Age 18 to 70 years
• ASA physical status I to III
• Ability to follow the protocol.

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Exclusion Criteria

• Age <18 or >70 years of age
• BMI above 40
• Contraindications to peripheral nerve blockade
• Pregnancy
• Chronic pain condition requiring opioid intake at home
• Allergy to opioids or local anesthetics
• Patient refusal

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Sham block	Sham block	Ultrasound-guided injection of equal volume of normal saline in the same location as would for a circum-psoas block.
Ultrasound guided circum-psoas block	Circum-psoas Block	Injection of 20ml 0.2% ropivacaine around the antero-lateral margin of psoas major muscle at the level of iliac crest with an in-plane approach under ultrasound guidance. Then the transducer was placed at the level of Lumbar vertebra 5 to obtain the paramedian transverse plane of the intertransverse ligament and lumbosacral ligament. An additional 20ml 0.2% ropivacaine was injected when the needle punctured the lumbosacral ligament.

Primary Outcome Measures

Name	Time	Method
pain severity at 6 hours postoperatively	6 hours postoperatively	Postoperative pain assessed with NRS pain score (NRS 0: no pain 10: pain as bad as can be) at 1, 6, 12, 24 hours postoperatively. However, to be more precise in our assessment, the effectiveness of each intervention was defined as a reduction in the pain at 6 hours postoperatively.

Secondary Outcome Measures

Name	Time	Method
Postoperative opioid consumption	up to the first 24 hours postoperatively	Cumulative 24-hr postoperative opioid consumption
Postoperative nausea and vomiting	up to the first 24 hours postoperatively	Nausea and vomiting intensity score measured by numeric rank score (0:no nausea and no vomiting, 1: have nausea, no vomiting, 2: once vomiting, 3: two or more vomiting).
neurologic evaluation	1, 6, 24 hours postoperatively	The dermatomal coverage of sensory block was evaluated by using a cool roller at 1, 6, 24 hours post-surgery. Motor strength was assessed by the following criteria (0: none; 1: muscle flicker without movement; 2: movement, but not against gravity; 3: movement against gravity; 4: movement against some resistance; 5: normal strength).
Patient satisfaction	at the end of 24 hours postoperatively	Patient satisfaction measured using a numeric rating scale 0 to 10 (0 = unsatisfied; 10 =very satisfied)