The Efficacy of Pain Control After Total Hip Replacement Between Ultrasound Guide Supra-inguinal Fascia Iliaca Block and Intrathecal Morphine: A Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Intrathecal morphine
- Conditions
- Total Hip Replacement
- Sponsor
- Mahidol University
- Enrollment
- 98
- Locations
- 1
- Primary Endpoint
- Time to first analgesic request (PCA fentanyl)
- Last Updated
- 6 years ago
Overview
Brief Summary
Total hip replacement is one of major orthopedic surgery which result in severe postoperative pain especially at first 24 hours. Ultrasound guided regional anesthesia has become a part of multimodal analgesia.Ultrasound guided supra-inguinal fascia iliaca block is a new technique which can consistently cover femoral and lateral femoral cutaneous nerve. And with large volume (40ml), it may cover obturator nerve. This technique already proved to be useful for acute pain control in hip fracture or postoperative control in dynamic hip screw or nail insertion operation. However, it has not been compared with intrathecal morphine for total hip replacement yet.
Detailed Description
By using combine ultrasound guided supra-inguinal fascia iliaca block with periarticular infiltration with mutimodal analgesic drugs will have longer duration time to first rescue analgesic drug compared with combine intrathecal morphine with periarticular infiltration with multimodal analgesic drugs.
Investigators
Eligibility Criteria
Inclusion Criteria
- •elective surgery of primary total hip replacement, body weight ≥40kg and BMI ≤35 kg/m2, competence to consent
Exclusion Criteria
- •contraindication to regional anesthesia, allergy to study drugs, skin infection at supra-inguinal fascia iliaca injection point, neurological deficit affecting the lower extremities, inability to use patient-controlled analgesia, GFR \<50 mL/min
Arms & Interventions
Intrathecal morphine
Intrathecal morphine 0.1 mg, A sham subcutaneous injection of 0.5 ml normal saline at inguinal area
Intervention: Intrathecal morphine
Ultrasound guided supra-inguinal fascia iliaca block
0.25% bupivacaine 40 ml
Intervention: Ultrasound guided supra-inguinal fascia iliaca block
Outcomes
Primary Outcomes
Time to first analgesic request (PCA fentanyl)
Time Frame: 48 hours
Whether ultrasound guided supra-inguinal fascia iliaca block can increase pain free period of patients undergo total hip replacement under spinal block compare with intrathecal morphine or not
Secondary Outcomes
- Pain score(48 hours)
- Amount of rescue analgesic drugs(48 hours)