Ultrasound Guided Quadratus Lumborum Block for Post Operative Analgesia After Hip Arthroplasty

Not Applicable

• Conditions: Pain, Postoperative
• Interventions: Procedure: Anterior Quadratus lamborum block

• Registration Number: NCT03502369
• Lead Sponsor: Alexandria University

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 Timeline

• Status Verified: 2018-04
• Study First Submitted: 2018-04-11
• Study First Submitted QC: 2018-04-11
• Last Update Submitted: 2018-04-17
• Study First Posted: 2018-04-18
• Last Update Posted: 2018-04-19
• Study Start: 2018-09
• Primary Completion: 2019-01
• Study Completion: 2019-03

Recruitment & Eligibility

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

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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
QL group	Anterior Quadratus lamborum block	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.

Primary Outcome Measures

Name	Time	Method
Pain intensity assessment	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 Outcome Measures

Name	Time	Method
Total amount of post operative morphine (mg).	any time in the first 24 post operative hours.	Total amount of post operative morphine (mg) used as rescue analgesia and the first time of its request.

Trial Locations

Locations (1)

Alexandria faculty of medicine; 🇪🇬 Alexandria, Egypt