Quadratus Lumborum Block Versus Fascia Iliaca Block for Hip Arthroplasty: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 34
- 试验地点
- 2
- 主要终点
- Duration of analgesia
研究概览
简要总结
Quadratus lumborum block is a newly developed block with good performance in lower abdominal surgery. In a cadaveric study, the spread of local anesthetic in the anterior approach of QL block (QL3) was reported to cover nerve roots from T10 to L3. Thus, it was hypothesized that this approach could be used in hip surgeries with minimal motor affection.
This study aims to compare QL3 block and suprainguinal Fascia Iliaca block in the duration of postoperative analgesia, pain scores, motor power in quadriceps muscle, and side effects.
详细描述
A randomized, controlled, double blinded, trial will be conducted in Cairo university hospital. Written informed consent will be obtained from all participants. Randomization will be achieved using a computer-generated sequence. Concealment will be achieved using opaque envelopes. Patients scheduled for hip replacement surgeries under subarachnoid block (SAB). e.g. hip hemiarthroplasty, total hip arthroplasty.
On arrival of the patients to regional anesthesia room, patients will be secured with 18-gauge intravenous cannula, and will receive ondansetron (4 mg), and dexamethasone (8 mg IV). Monitoring will include Electrocardiography, non-invasive arterial blood pressure, and pulse oximetry.
Before receiving subarachinoid block, patients will be randomly assigned into one of the two study groups:
QLB Group (n=17): this group will receive ultrasound-guided transmuscular quadratus lumborum block; (Anterior QLB or QLB III) FIB Group (n=17): this group will receive suprainguinal fascia iliaca block To achieve double blinding, patients will receive the block with 30 mL bupivacaine (0.25%) by the anesthetist. Another doctor not involved in the block procedure will evaluate the patients postoperative.
After finishing the block & assessment of motor power of quadriceps femoris muscle , patient will receive midazolam (2mg intravenous), and then transferred to operation room.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients scheduled for hip replacement surgeries under subarachnoid block (SAB). e.g. hip hemiarthroplasty, total hip arthroplasty.
排除标准
- •Coagulopathy, infection at the injection site,.
- •Allergy to local anesthetics.
- •Severe cardiopulmonary disease (≥ASA IV),.
- •Diabetic or other neuropathies.
- •Patients receiving opioids for chronic analgesic therapy.
- •Contraindication to spinal anesthesia.
- •Inability to comprehend visual analogue scale (VAS).
研究组 & 干预措施
QLB Group
this group will receive ultrasound-guided transmuscular quadratus lumborum block; (Anterior QLB or QLB III)
干预措施: quadratus lumborum block; (Anterior QLB or QLB III) (Procedure)
QLB Group
this group will receive ultrasound-guided transmuscular quadratus lumborum block; (Anterior QLB or QLB III)
干预措施: Subarachnoid block (Procedure)
FIB Group
this group will receive suprainguinal fascia iliaca block
干预措施: suprainguinal fascia iliaca block (Procedure)
FIB Group
this group will receive suprainguinal fascia iliaca block
干预措施: Subarachnoid block (Procedure)
结局指标
主要结局
Duration of analgesia
时间窗: 24 hours postoperative
If the visual analogue scale (VAS) is 4 or more, a 2 mg morphine increment will be added per time to maintain a resting VAS at \<3 with maximum total 24-hours morphine 10 mg.
次要结局
- Onset of sensory block of quadratus lumborum block and fascia iliaca block(30 minutes)
- Time to first postoperative analgesic request(24 hours postoperative)
- Total morphine requirements(24 hours postoperative)
- Assessment of the quadriceps muscle power.(24 hours)
- Time needed to perform the block(30 minutes)
- incidence of pain during positioning for spinal block(30 minutes)
- Static visual analogue pain scale(24 hours postoperative)
- Dynamic visual analogue pain scale(24 hours postoperative)
研究者
Bassant M. Abdelhamid
associate professor
Cairo University