Fascia Iliaca Blocks for Pain Control After Total Hip Arthroplasty

Phase 4

Completed

Interventions: Procedure: Fascia iliaca compartment block
Drug: Placebo
Drug: Bupivacaine

Brief Summary: The fascia iliaca compartment block (FICB) is a regional block that anesthetizes the femoral, obturator, and lateral femoral cutaneous nerves around the hip. The purpose of this study is to determine whether FICB can reduce postoperative pain and increase progress with physical therapy after total hip arthroplasty (THA). This randomized, double-blind, clinical trial will randomize patients to receive either a FICB or placebo after THA. The primary outcomes will be pain scores reported by the patient post-operatively.

Detailed Description: The FICB is a regional block that anesthetizes the femoral, obturator, and lateral femoral cutaneous nerves around the hip joint. There have been numerous study assessing it's ability to control pain in the pre and post operative period in patients with hip fractures. However, there is a limited amount of literature on its efficacy after total hip arthroplasty, and no data when a posterior surgical approach to the hip was utilized. Because regional blocks have been shown to decrease pain post operatively after total knee arthroplasty, we hypothesize that the FICB will decrease pain and narcotic use in patients after total hip arthroplasty. This study will aim to recruit 120 patients that will be randomized to receive a FICB or placebo in the recovery room within 30 minutes of leaving the OR. Once the intervention is complete we will collect data on the patients' pain levels, morphine equivalents of narcotic that they used, and how well they worked with physical therapy during their inpatient stay.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Fascia Iliaca Compartment Block	Fascia iliaca compartment block	A Fascia Iliaca Compartment Block will be administered in the block room.
Control	Placebo	The patients will be brought back to the block room, prepped, and a blunt needle will be touched to the skin. A band aid will be applied over the site.
Fascia Iliaca Compartment Block	Bupivacaine	A Fascia Iliaca Compartment Block will be administered in the block room.

Primary Outcome Measures

Name	Time	Method
Averaged Pain Score	Pain scores were at 30 minute intervals for the first hour post-operative, hourly for the next 4 hours, 2 hour intervals for the next 12 hours, then at 4 hour intervals until the 48 hour post-operative or discharge. The mean of these scores is reported.	Analog pains scale 0-10. A pain score of 10 represents maximum pain and a pain score of 0 represents no pain.
Morphine Equivalents Consumed	Postoperative inpatient stay, which averages approximately two days.	Total morphine equivalents (consumed at 4-hour time intervals) received in postoperative inpatient stay.

Secondary Outcome Measures

Name	Time	Method
Walking Distance	Post operative day one	The distance the patient is able to walk with physical therapy during their first session
Time to Up-and-go	Post operative day one	Time to up and go test performed on the first postoperative day. This test is administered by having the patient sit in a chair. When the patient is instructed to start, the stand from the chair, walk to a marker ten feet away from the chair, turn around, return to the chair, and sit back down. The time is measured as the time from when the start command is given to when they are returned to a seated position.
Time to Discharge Readiness	Every 6 hours after surgery until completion of inpatient stay, an average of two days days after surgery	Time in hours since surgery to when the patient's pain is controlled on oral medications, has cleared physical and occupational therapy, and has no medical issues that require inpatient treatment.