Lumbar Erector Spinae Plane Block vs Fascia Iliaca Block vs Lumbar Plexus Block for Postoperative Analgesia for Total Hip Arthroplasty

Tanta University

Status: Completed

Conditions: Fascia Iliaca Block; Total Hip Arthroplasty; Lumbar Plexus Block; Lumbar Erector Spinae Plane Block; Analgesia

Treatments: Other: Lumbar Plexus Block; Other: Fascia Iliaca Block; Other: Lumbar Erector Spinae Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06573931

36264PR760/7/24

Details and patient eligibility

About

This study aims to compare lumbar erector spinae plane block, fascia iliaca block, and lumbar plexus block for postoperative analgesia for hip surgery.

Full description

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.

Enrollment: 90 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-III.
• Undergoing total hip arthroplasty under spinal anesthesia.

Exclusion criteria

• 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.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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90 participants in 3 patient groups

Lumbar Erector Spinae Plane Block

Experimental group

Description:

Patients will receive lumbar erector spinae plane block at the end of surgery.

Treatment:

Other: Lumbar Erector Spinae Plane Block

Fascia Iliaca Block

Experimental group

Description:

Patients will receive fascia iliaca block at the end of surgery.

Treatment:

Other: Fascia Iliaca Block

Lumbar Plexus Block

Experimental group

Description:

Patients will receive lumbar plexus block at the end of surgery.

Treatment:

Other: Lumbar Plexus Block