QLESP Block Versus Periarticular Infiltration for Postoperative Analgesia in Hip Surgery

Not Applicable

Recruiting

• Conditions: Regional Anaesthesia
• Interventions: Drug: ropivacaine

• Registration Number: NCT06688136
• Lead Sponsor: Huazhong University of Science and Technology

Brief Summary

Local and/or regional analgesia techniques are critical components of an optimal multimodal analgesia technique, as they have been shown to improve pain relief as well as reduce opioid requirements. Optimal pain management technique balances pain relief with concerns about safety and adverse effects associated with analgesic techniques. Periarticular infiltration (PAI) is increasingly included as a component of multimodal analgesia technique for patients undergoing THA, as it provides improved postoperative pain relief with no effects on quadriceps function. Recently, our group has developed a novel transmuscular quadratus lumborum and modified erector spinae plane (QLESP) block, which is characterized by simple operation, high efficiency, and wide dermatomal coverage of sensory block. Therefore, we designed a randomized controlled trial to compare ultrasound-guided QLESP with PAI as a component of non-opioid analgesic regimen in patients undergoing THA via posterior approach. We hypothesized that QLESP would provide superior analgesia when compared with PAI. The primary outcome of the study was postoperative opioid requirements within the initial 24-h postoperative period after THA. The secondary objectives were to compare pain scores, postoperative quadriceps strength, the time to first rescue analgesia, opioid-related adverse effects, time to ambulation, and the time to hospital discharge.

Detailed Description

Not available

Study Timeline

• Status Verified: 2024-11
• Study First Submitted: 2024-11-11
• Study First Submitted QC: 2024-11-13
• Study First Posted: 2024-11-14
• Study Start: 2024-11-18
• Last Update Submitted: 2024-11-18
• Last Update Posted: 2024-11-20
• Primary Completion: 2025-08-30
• Study Completion: 2025-09-15

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

1. Age 18-65 yrs
2. American Society of Anesthesiologists classification 1-3
3. Body mass index between 20 and 35 (kg/m2)
4. Undergo elective primary unilateral THA via a posterolateral approach
5. Informed consent

Exclusion Criteria

1. A known allergy to the drugs being used
2. Pre-existing neuropsychiatric disorders or language barrier
3. Analgesics intake, history of substance abuse
4. Contraindications to peripheral nerve block
5. Acute cerebrovascular disease
6. Severe liver failure

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Infiltration	ropivacaine	Periarticular infiltration of 40 ml of 0.4% ropivacaine prior to closing the incision
transmuscular quadratus lumborum and modified erector spinae plane (QLESP) block	ropivacaine	Twenty ml of 0.4% ropivacaine was administered between the erector spinae muscle and the transverse process. Twenty ml of 0.4% ropivacaine was subsequently given between the quadratus lumborum and the psoas major muscles.

Primary Outcome Measures

Name	Time	Method
The cumulative opioid consumption	At 24 postoperative hours

Secondary Outcome Measures

Name	Time	Method
The pain scores determined by the numeric rating scale (NRS, 0-10)	Postoperative 48 hours
Quadriceps strength	Postoperative 48 hours
Postoperative hospital length of stay	Up to 6 weeks

Trial Locations

Locations (1)

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; 🇨🇳 Wuhan, Hubei, China