LPB Combined with QLB Using Single-needle Technique (LPQLB-SNT) for Hip Arthroplasty

Shanghai Jiao Tong University

Status: Completed

Conditions: Osteonecrosis of Femoral Head; Hip Fractures; Anesthesia, Local; Hip Osteoarthritis

Treatments: Procedure: T12 block; Procedure: General anesthesia with tracheal intubation; Procedure: L3 LPB; Drug: 0.375%ropivacaine 40 ml (Raropin); Procedure: L4 LPB; Drug: 0.375%ropivacaine 25 ml (Raropin); Procedure: L3 QLB

Study type: Interventional

Funder types: Other

Identifiers

NCT04266236

2020-031

Details and patient eligibility

About

Total hip arthroplasty (THA) is one of the most successful orthopedic procedures to effectively relieve pain and restore function in patients with hip osteoarthritis, osteonecrosis of femoral head and hip fracture.The Lumbar Plexus Block (LPB) is currently used as the standard regional anesthesia technique to provide postoperative pain management after THA. The lumbar plexus (LP) originates from T12 to L5. In general, multiple-needle nerve blockade procedure is needed to block different branches of LP. Therefore, we need more time to finish the regional anethesia procedure and it's not easy for an inexperienced anesthesiologist to master the technique absolutely. In addition, multiple injections will increase the discomfort of the patients. We aim to investigate the effects of lumbar plexus combined with quadratus lumborum block using single-needle technique with Shamrock method as an alternative regional anesthesia.

Enrollment: 84 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Body mass index (BMI) between 18.5 and 30kg/m2 and the weight ≥50kg
2. American Society of Anesthesiologists (ASA) classification I-II
3. Postero-lateral operative incision approach unilateral hip arthroplasty
4. Aged 18-75

Exclusion criteria

1. Patient refusal
2. Patients with coagulopathy or on therapeutic anticoagulation
3. Pregnancy
4. Multiple trauma
5. Hypersensitivity or allergy to ropivacaine
6. History of ankylosing spondylitis or spinal surgery
7. Lower extremity neuropathy
8. Unable to communicate

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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84 participants in 3 patient groups

L3 LPB technique (P group)

Active Comparator group

Description:

ultrasound-guided shamrock approach L3 lumbar plexus block with single-needle technique

Treatment:

Drug: 0.375%ropivacaine 25 ml (Raropin)

Procedure: L3 LPB

Procedure: General anesthesia with tracheal intubation

T12 combined with L3 and L4 LPB technique (TP group)

Active Comparator group

Description:

ultrasound-guided posterior approach thoracic 12 combined with L3 and L4 lumbar plexus block with mulitple-needle technique

Treatment:

Procedure: L4 LPB

Drug: 0.375%ropivacaine 40 ml (Raropin)

Procedure: L3 LPB

Procedure: General anesthesia with tracheal intubation

Procedure: T12 block

L3 LPB combined with QLB (LPQLB-SNT, PQ group)

Experimental group

Description:

ultrasound-guided shamrock approach L3 lumbar plexus block combined with quadratus lumborum block with single-needle technique

Treatment:

Procedure: L3 QLB

Drug: 0.375%ropivacaine 40 ml (Raropin)

Procedure: L3 LPB

Procedure: General anesthesia with tracheal intubation