Comparing the two methods of analgesia for postoperative pain in patients undergoing total hip arthroplasty

Phase 2/3

Not yet recruiting

Conditions: Osteoarthritis of hip, unspecified, (2) ICD-10 Condition: M169||Osteoarthritis of hip, unspecified, (3) ICD-10 Condition: M169||Osteoarthritis of hip, unspecified, (4) ICD-10 Condition: 7||Osteopathic, (5) ICD-10 Condition: 7||Osteopathic,

Registration Number: CTRI/2022/04/042165

Lead Sponsor: CHRISTIAN MEDICAL COLLEGE

Brief Summary: Early mobilization following hip surgeries is thought to be an imperative part of postoperative management and has been associated with a reduction in postoperative complications such as thromboembolism, pneumonia, wound breakdown, pressure ulcers and delirium. Postoperatve analgesia plays an important role in early mobilization and initiation of physiotherapy. Analgesic techniques should aim to provide optimal pain relief while minimizing postoperative nausea, vomiting, hypotension and motor blockade. Peripheral nerve blocks are the choice of postoperative analgesia for hip surgeries as they facilitate effective joint mobilization, while limiting reflex muscle spasm and avoiding the side effects of continuous epidural analgesia(hypotension, urinary retention) and PCA morphine (postoperative nausea, vomiting, sedation). Continuous psoas compartment blockade posterior approach has been shown to provide good postoperative analgesia with postoperative pain scores. This is recently described technique, whereas epidural analgesia has been the standard of care at our institution for postoperative analgesia following total hip arthroplasty. We therefore aim to compare the efficacy of ultrasound guided continuous psoas subfascial blockade to continuous lumbar epidural blockade for postoperative analgesia in total hip replacement surgeries. Patients undergoing unilateral and bilateral total hip arthroplasty will be randomized into group P and Group E. The intraoperative guidelines for both groups will be standardized. Psoas subfascial block will be performed, either pre or postoperatively in a designated block area, a catheter placed under ultrasound guidance and secured. Administration of intermittent boluses of analgesics and assessment of postoperative pain scores will be carried out by the pain team. In group E, prior to the induction of anaesthesia epidural catheter will be placed and postoperative pain will be managed by continuous infusion of the drug as per the current protocol. In both the groups the patients will be assessed for pain scores at rest and on ambulation till the time of discharge. Functional recovery will also be compared between the two groups with modified harris hip score.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 100

Inclusion Criteria

Patients undergoing unilateral and bilateral total hip arthroplasty, ASA I,II,stable ASA III patients, Age>18 years.

Exclusion Criteria

ASA IV, Age<18 years, Patients with deranged coagulation profile, Allergy to medication which is included in the protocol, Patients with peripheral neuropathy.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Postoperative pain scores at rest and movement will be aseessed eighth hourly till the time of discharge	Postoperative pain scores at rest and movement will be aseessed eighth hourly till the time of discharge

Secondary Outcome Measures

Name	Time	Method
Functional recovery,	Requirement of rescue analgesia,

Trial Locations

Locations (1): DEPARTMENT OF ANAESTHESIA, CHRISTIAN MEDICAL COLLEGE, VELLORE
🇮🇳
Vellore, TAMIL NADU, India
DEPARTMENT OF ANAESTHESIA, CHRISTIAN MEDICAL COLLEGE, VELLORE
🇮🇳Vellore, TAMIL NADU, India
Kiruthiga
Principal investigator
8903544236
kiruthigaravi06@gmail.com