Lumbar Erector Spinae Plane Block vs Fascia Iliaca Block vs Lumbar Plexus Block for Postoperative Analgesia for Total Hip Arthroplasty

Not Applicable

Completed

• Conditions: Analgesia; Lumbar Erector Spinae Plane Block; Fascia Iliaca Block; Lumbar Plexus Block; Total Hip Arthroplasty
• Interventions: Other: Lumbar Erector Spinae Plane Block; Other: Fascia Iliaca Block; Other: Lumbar Plexus Block

• Registration Number: NCT06573931
• Lead Sponsor: Tanta University

Brief Summary

This study aims to compare lumbar erector spinae plane block, fascia iliaca block, and lumbar plexus block for postoperative analgesia for hip surgery.

Detailed Description

Approximately 500,000 hip arthroplasties are performed each year in the United States. Traditionally, this procedure has been performed under general anesthesia. However, neuraxial and regional anesthesia have become more commonly utilized to aid in postoperative analgesia and reduce the side effects of opioids, namely sedation, nausea, and vomiting. Postoperative pain control has a significant impact on earlier ambulation, initiation of physical therapy, better functional recovery, and overall patient satisfaction.

Lumbar erector spinae plane block (LESPB) was reported to lead to effective postoperative analgesia in hip and proximal femoral surgery.

The fascia iliaca block (FIB) is an established and effective technique, especially when US guidance and proximal approaches are used.

lumbar plexus block (LPB) could be safe because of the targeted somatic nerve block in the psoas region which prevents dispensable sympathetic block even in cardiovascular-compromised patients.

Study Timeline

• Study First Submitted: 2024-08-24
• Study First Submitted QC: 2024-08-24
• Study First Posted: 2024-08-27
• Study Start: 2024-08-29
• Primary Completion: 2025-02-15
• Study Completion: 2025-02-15
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-15
• Last Update Posted: 2025-04-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

• Age ≥ 18 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-III.
• Undergoing total hip arthroplasty under spinal anesthesia.

Exclusion Criteria

• Obesity (Body Mass Index > 30 kg/m2).
• Allergy to any drug used in the study.
• Contraindications to spinal anesthesia (such as Thrombocytopenia (platelets <100,000/mCL) and coagulopathy (INR >1.4 or insufficient time since stopping systemic anticoagulation)).
• Epilepsy.
• Psychiatric disease.
• Pre-existing neurologic deficits or neuropathies.
• Pregnancy.
• Pre-existing alcohol/opioid use disorder.
• Previously diagnosed with chronic pain.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Lumbar Erector Spinae Plane Block	Lumbar Erector Spinae Plane Block	Patients will receive lumbar erector spinae plane block at the end of surgery.
Fascia Iliaca Block	Fascia Iliaca Block	Patients will receive fascia iliaca block at the end of surgery.
Lumbar Plexus Block	Lumbar Plexus Block	Patients will receive lumbar plexus block at the end of surgery.

Primary Outcome Measures

Name	Time	Method
Time to the 1st rescue analgesia	24 hours postoperatively	Time to the first request for the rescue analgesia (time from end of block to first dose of morphine administrated) will be recorded.

Secondary Outcome Measures

Name	Time	Method
Total morphine consumption in the 1st 24h	24 hours postoperatively	Rescue analgesia will be provided by patient-controlled analgesia (PCA) with intravenous morphine (no basal rate; bolus 1 mg, lockout 10 minutes, maximum dose 20 mg in 4 h), which will be started if the numeric rating scale (NRS)\> 3. NRS will be assessed at PACU, 4, 8, 16, and 24 h postoperatively.
Incidence of adverse events	24 hours postoperatively	Incidence of adverse events such as Bradycardia, hypotension, postoperative nausea and vomiting (PONV), or any other complication will be recorded.
Degree of pain	24 hours postoperatively	Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at PACU, 4, 8, 16, and 24 h postoperatively.

Trial Locations

Locations (1)

Tanta University; 🇪🇬 Tanta, El-Gharbia, Egypt