Lumbar Plexus Block for Postoperative Pain Control After Hip Arthroscopy. A Randomized Controlled Trial (LPB Hip Scope)

Hospital for Special Surgery (HSS)

Status and phase: Completed; Phase 4

Conditions: Postoperative Pain

Treatments: Procedure: Control; Procedure: Lumbar Plexus Blockade

Study type: Interventional

Funder types: Other

Identifiers

NCT01286805

10038 (Registry Identifier)

Details and patient eligibility

About

The purpose of this study is to determine whether the use of a lumbar plexus block for arthroscopic hip surgery is superior to oral and intravenous opioid pain medications alone in treating pain. In addition, the study will examine whether lumbar plexus blocks reduce the total amount of pain medication needed, and therefore reduce the side effects of these medicines and increase patient satisfaction. It is hypothesized that addition of the lumbar plexus block will significantly reduce patients' postoperative pain.

Enrollment: 83 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists (ASA) Class 1-3
• Patients aged 18 to 65 years
• Patients scheduled for primary, unilateral arthroscopic hip surgery by Dr. Kelly, Dr. Coleman, or Dr. Anil Ranawat
• Planned use of neuraxial anesthesia
• Body Mass Index less than 35
• Ability to follow study protocol

Exclusion criteria

• Chronic opioid use (defined as daily or almost daily use of opioids for >3 months)
• Contraindication to combined spinal-epidural anesthesia including but not limited to bleeding disorder, use of clinically relevant anticoagulant or antiplatelet medications, and anatomic abnormalities.
• Contraindication to lumbar plexus block including but not limited to bleeding disorder, use of clinically relevant anticoagulant or antiplatelet medications, and anatomic abnormalities.
• Infection at the injection site(s)
• Allergy to any of the study medications
• Contraindication to a short course of NSAIDs (renal failure, intolerance)
• ASA Class 4-5
• Patient refusal
• Patients younger than 18 years old and older than 65
• Patients with any known indwelling hardware of the lumbar spine.
• Patients with a peripheral neuropathy of the surgical extremity
• Non-English speaking patients

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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83 participants in 2 patient groups, including a placebo group

Lumbar Plexus Blockade + CSE

Experimental group

Description:

The study group will receive a lumbar plexus blockade with 30 mL of 0.25% bupivacaine with 1:200,000 epinephrine, followed by a combined spinal-epidural.

Treatment:

Procedure: Lumbar Plexus Blockade

Control Group

Placebo Comparator group

Description:

The control group will receive only a combined spinal-epidural.

Treatment:

Procedure: Control