Comparison of the Effects of Quadroiliac Plane Block Versus Suprainguinal Fascia Iliaca Compartment Block on Postoperative Pain in Hip Surgery
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Numeric Rating Scale (NRS) Scores
研究概览
简要总结
The aim is to compare the postoperative analgesic effects of Quadroiliac Plane Block (QIPB) and Suprainguinal Fascia Iliaca Compartment Block (SIFICB) in patients undergoing hip surgery.
详细描述
Patients were divided into two randomized groups: Group 1 (QIPB group, n=30) and Group 2 (SIFICB group, n=30). All patients will receive the same standard general anesthesia per hospital protocol. All blocks will be applied with the same ultrasonography and block equipment, and by the same physician. After the anesthesia induction, patients in Group 1 will receive Quadroiliac Plane Block (QIPB) with 40 mL of 0.25% bupivacaine. Patients in Group 2 will receive Suprainguinal Fascia Iliaca Compartment Block (SIFICB) with 30 mL of 0.25% bupivacaine. All patients will receive Paracetamol 1gr and Dexketoprofen 50mg intravenous (IV) 10 minutes prior to skin closure. Routine analgesic procedure consisting of 3x400mg Ibuprofen will be followed postoperatively for 24 hours. Numeric Rating Scale (NRS) will be used to assess postoperative pain on 1st, 6th, 12th, 18th and 24th hours after the surgery. Tramadol 1mg/kg IV will be administered as a rescue analgesic for all patients if NRS score is higher than 4. Total Tramadol consumption will be calculated.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 99 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients over 18 years of age who underwent percutaneous nephrolithotomy under general anesthesia and were I-II-III according to the American Society of Anesthesiologists (ASA) risk classification were included in the study.
排除标准
- •patients who did not give consent,
- •patients with coagulopathy,
- •patients with signs of infection at the block application site,
- •patients using anticoagulants,
- •patients with known allergies to any of the study drugs,
- •patients with unstable hemodynamics,
- •patients who could not cooperate during postoperative pain assessment
- •patients who wanted to withdraw from the study,
- •patients with alcohol and drug addiction,
- •patients with musculoskeletal abnormalitie
研究组 & 干预措施
Quadro-İliac Plane Block(QİPB)
For this group, after the surgical procedure is completed, the patient will be placed in a lateral position with the operated side facing up, and a QIPB will be performed. With the patient in the lateral position, the spinous process of the L3 vertebra will first be imaged with an ultrasound probe positioned transversely in the midline. Then, by slightly shifting the probe laterally, the transverse process of the vertebra will be visualized within the erector spinae muscle. The probe will then be rotated in the sagittal plane and advanced caudally about 1 cm, visualizing the crista iliaca. On the cranial side of the crista iliaca, the erector spinae muscle, quadratus lumborum, and psoas major muscles will be visualized sequentially. With the needle direction cranial to caudal, the crista iliaca will be gently touched, and the needle will be positioned between the erector spinae and the quadratus lumborum muscle. After injecting 40 ml of 0.25% bupivacaine, the needle will be injected.
干预措施: Quadro-İliac Plane Block(QİPB) (Procedure)
Suprainguinal Fascia Iliaca Compartiment Block (SIFICB)
Probe Placement: A high-frequency linear ultrasound probe is placed in a sagittal orientation over the Anterior Superior Iliac Spine (ASIS) and then moved medially.
Anatomical Landmark: The key visual target on the ultrasound screen is the "bowtie" sign, which is formed by the junction of the sartorius and internal oblique muscles over the iliacus muscle.Injection Point: The target for injection is the potential space located directly beneath the fascia iliaca (seen as a bright, hyperechoic line) and superficial to the iliacus muscle.Needle Insertion: The block needle is advanced using an "in-plane" technique (parallel to the probe's long axis), typically from a caudal-to-cranial direction (from bottom to top).Injection: After confirming correct needle tip placement with hydrodissection (visualizing fluid separating the fascia from the muscle), 30-40 mL of local anesthetic is slowly injected. The spread of the anesthetic proximally (upward) beneath the fascia is monitored in real-time
干预措施: Suprainguinal Fascia Iliaca Compartiment Block (Procedure)
结局指标
主要结局
Numeric Rating Scale (NRS) Scores
时间窗: Postoperative 24 hours
Numerical rating scale is used for pain assessment. The scores of the numerical rating scale changes between 0 to 10 points. 10 points mean "the most severe pain that the patient ever had". 0 point means "there is no pain." Higher scores mean worse outcome.
次要结局
- Total tramadol consumption(Postoperative 24 hours)
研究者
Oguz Gundogdu
Associate Professor
Cumhuriyet University