CPB for Arthroscopic Hip Surgery

The Second Hospital of Shandong University

Status: Not yet enrolling

Conditions: Opioid Use; Acute Pain

Treatments: Procedure: Sham block; Procedure: Circum-psoas Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06337968

Circum-Psoas Block LN

Details and patient eligibility

About

Arthroscopic hip surgery is being increasingly performed to treat both intraarticular and extraarticular hip diseases. Despite the minimally invasive approach, patients undergoing arthroscopic hip surgery still suffer severe pain due to the complex nature of hip innervation. Postoperative pain reduces patient satisfaction and delay patient recovery and discharge. The efficacy of regional anesthesia techniques in postoperative pain management have been proved in various surgeries. However, it remains controversial whether or not peripheral nerve blocks can significantly improve postoperative analgesia after hip arthroscopy.

Several studies have shown that the fascia iliac block cannot improve postoperative analgesia for hip arthroscopy because it blocks only some branches of the lumbar plexus but not the sacral plexus. Circum-Psoas Block (CPB) which has been defined in recent years is able to block the lumbar plexus nerves as well as sacral plexus such as the sciatic, superior gluteal, and inferior gluteal nerves. Therefore, the investigators predict that it can provide effective postoperative analgesia for hip arthroscopy. In this study, the researchers aim to investigate the effectiveness of CPB in hip arthroscopy.

Enrollment: 74 estimated patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Primary unilateral ambulatory hip arthroscopy
• Age 18 to 70 years
• ASA physical status I to III
• Ability to follow the protocol.

Exclusion criteria

• Age <18 or >70 years of age
• BMI above 40
• Contraindications to peripheral nerve blockade
• Pregnancy
• Chronic pain condition requiring opioid intake at home
• Allergy to opioids or local anesthetics
• Patient refusal

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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74 participants in 2 patient groups, including a placebo group

Ultrasound guided circum-psoas block

Active Comparator group

Description:

Injection of 20ml 0.2% ropivacaine around the antero-lateral margin of psoas major muscle at the level of iliac crest with an in-plane approach under ultrasound guidance. Then the transducer was placed at the level of Lumbar vertebra 5 to obtain the paramedian transverse plane of the intertransverse ligament and lumbosacral ligament. An additional 20ml 0.2% ropivacaine was injected when the needle punctured the lumbosacral ligament.

Treatment:

Procedure: Circum-psoas Block

Sham block

Placebo Comparator group

Description:

Perform ultrasound scanning without puncture.

Treatment:

Procedure: Sham block