Lumbar Erector Spinae Plane Block vs Fascia Iliaca Block vs Lumbar Plexus Block for Postoperative Analgesia for Total Hip Arthroplasty: A Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 90
- 试验地点
- 2
- 主要终点
- Time to the 1st rescue analgesia
研究概览
简要总结
This study aims to compare lumbar erector spinae plane block, fascia iliaca block, and lumbar plexus block for postoperative analgesia for hip surgery.
详细描述
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.
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
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥ 18 years.
- •Both sexes.
- •American Society of Anesthesiology (ASA) physical status I-III.
- •Undergoing total hip arthroplasty under spinal anesthesia.
排除标准
- •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.
结局指标
主要结局
Time to the 1st rescue analgesia
时间窗: 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.
次要结局
- Total morphine consumption in the 1st 24h(24 hours postoperatively)
- Incidence of adverse events(24 hours postoperatively)
- Degree of pain(24 hours postoperatively)
研究者
Mohammed Said ElSharkawy
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tanta University