Suprainguinal Fascia Iliaca (SIFI) Block Improves Analgesia Following Total Hip Arthroplasty

Phase 4

Terminated

Interventions: Procedure: Sham block
Procedure: Suprainguinal fascia iliaca (SIFI) block
Drug: Saline
Drug: Ropivacaine

Brief Summary: The purpose of this study is to learn if using a suprainguinal fascia iliaca (SIFI) injection technique (also called a "nerve block") that numbs the nerves going to the side and front of the upper leg will improve pain control after surgery. The SIFI technique uses a numbing solution (local anesthetics) that is injected next to nerves in the hip to reduce pain. This block may affect movement in the leg and make the legs weak. The amount of leg weakness is not known and assessment of this will be included in the study. Many institutions use the SIFI block for patients having total hip replacements, with the hope of providing good pain relief combined with improved mobility after surgery.

Recruitment & Eligibility

Inclusion Criteria

English speaking
between 18 and 75 years old
American Society of Anesthesiologists (ASA) 1-3 patients undergoing primary total hip arthroplasty

Exclusion Criteria

ASA 4 or 5
revision hip arthroplasty
diagnosis of chronic pain
daily chronic opioid use (over 3 months of continuous opioid use)
inability to communicate pain scores or need for analgesia
acute hip fracture
Infection at the site of block placement
Age under 18 years old or greater than 75 years old
Pregnant women
Intolerance/allergy to local anesthetics
Weight <50 kg
Suspected, or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years.
Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, may interfere with study assessments or compliance
Current or historical evidence of any clinically significant disease or condition that, in the opinion of the investigator, may increase the risk of surgery or complicate the subject's postoperative course.

Arm && Interventions

Group	Intervention	Description
Sham group	Sham block	The same nerve block technique as above, however using an inactive solution of salt water.
Suprainguinal Fascia Iliaca (SIFI) block	Suprainguinal fascia iliaca (SIFI) block	A nerve block technique using a numbing medication called ropivacaine.
Sham group	Saline	The same nerve block technique as above, however using an inactive solution of salt water.
Suprainguinal Fascia Iliaca (SIFI) block	Ropivacaine	A nerve block technique using a numbing medication called ropivacaine.

Primary Outcome Measures

Name	Time	Method
Numeric Pain Score at 4 Hours Postoperatively, as Measured by Numerical Rating Scale (NRS) 11	4 hours postoperatively	The NRS 11 ranges from 0 (no pain) to 10 (intense pain).

Secondary Outcome Measures

Name	Time	Method
Motor Strength, as Measured by Dynamometry	4 hours postoperatively	Reported as pounds per square inch (PSI).
Numeric Pain Score at 24 Hours, as Measured by NRS 11	24 hours	The NRS 11 ranges from 0 (no pain) to 10 (intense pain).
Cumulative Opioid Consumption	24 hours	Reported in IV morphine equivalents.
Ambulation, as Measured by Distanced Walked	post-op day 0