Randomized, Controlled, Double Blind Trial of Ultrasound Guided Quadratus Lumborum Block for Post Operative Analgesia After Hip Arthroplasty
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Alexandria University
- Enrollment
- 90
- Locations
- 2
- Primary Endpoint
- Pain intensity assessment
Study Overview
Brief Summary
The study evaluates the effectiveness of anterior quadratus lumborum block for post operative analgesia after hip arthroplasty. Half of the participants will receive ultrasound guided anterior quadratus lumborum block using 30ml bupivacaine 0.375%, while the other half will not receive the block ( control group).
Detailed Description
Sensory innervation of the hip region involves branches of the lumbar plexus and sacral plexus. Effective post operative analgesia can be approached by blocking the lumbar plexus at the level of the quadratus lumborum muscle. Quadratus lumborum block has several approach methods (anterior, lateral, posterior, and intramuscular). Anterior quadratus lumborum block also known as transmuscular QL block or QL3, the local anaesthetic (30ml of bupivacaine 0.375%) is injected between the psoas major muscle (PM) and the quadratus lumborum muscle (QL). Therefore, the anterior quadratus lumborum block may generate analgesia from T10 to L4 covering the sensory innervation of the hip region.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 80 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •American society of anesthesiologists physical status |-||| , scheduled to undergo unilateral hip replacement via lateral approach.
Exclusion Criteria
- •patient refusal.
- •History of neurological/neuromuscular, psychiatric, dementia preventing proper comprehension.
- •coagulation disorders.
- •History of allergy to the study medication.
- •Infection overlying the injection site.
Arms & Interventions
QL group
Anterior Quadratus lumborum block will be done for all patients of these group. Local anaesthetic (30ml of bupivacaine) will be injected in fascial plane between the quadratus lumborum muscle and Psoas major muscle by using the ultrasound.
Intervention: Anterior Quadratus lamborum block (Procedure)
C group
Patients of these group will be the control group. The will receive acetaminophen 1g every 8h, ketorolac 30mg ever 12h and as required morphine 2mg for post operative analgesia after hip arthroplasty.
Outcomes
Primary Outcomes
Pain intensity assessment
Time Frame: every hour for the first 4 post operative hours and then every 4 hours for the rest of the 24 post operative hours.
Patients will be trained to use visual analogue scale which consists of 10cm line, 0 cm equivalent to no pain and 10 cm denoting the worst imaginable pain.
Secondary Outcomes
- Total amount of post operative morphine (mg).(any time in the first 24 post operative hours.)
Investigators
Abdullah Gaber
Registeral
Alexandria University