Psoas Compartment Block Versus Periarticular Local Anesthetic for Total Hip Arthroplasty

William Beaumont Hospitals

Status and phase: Completed; Phase 4

Conditions: Osteoarthritis; Arthroplasty

Treatments: Drug: Ketorolac Tromethamine; Drug: Ropivacaine with NaCl; Drug: Epinephrine; Drug: Ropivacaine; Drug: Morphine

Study type: Interventional

Funder types: Other

Identifiers

NCT02658149

2015-422

Details and patient eligibility

About

The primary objective of this study is to examine whether there is a difference in the level of resting pain following total hip arthroplasty with an anterior approach with use of a psoas compartment block versus a local periarticular anesthetic infiltration

Full description

A single-center, prospective, randomized clinical trial with a total of 100 patients. One orthopaedic adult reconstruction surgeon at Beaumont Hospital Royal Oak (JJV) will perform all surgeries. After the patient has consented they will be randomized to one of the following two groups:

1. Psoas compartment block (n=50)
2. Periarticular local anesthetic infiltration (n=50),

The patient will be blinded to the study group.

Enrollment: 100 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients undergoing unilateral primary total hip arthroplasty by Dr. James Verner at Beaumont Hospital Royal Oak
• Have a diagnosis of primary osteoarthritis (i.e. degenerative joint disease)
• Surgical approach is anterior

Exclusion criteria

• Minors (age less than 18 years)
• Pregnant (surgically sterile, post-menopausal, or negative blood test)
• Previous ipsilateral hip surgery
• Lumbar instrumentation
• Acute trauma
• Rheumatoid arthritis
• Avascular necrosis
• Hip dysplasia
• Known sensitivity, allergy, or contraindication to anesthetics being used in the study
• Narcotic sensitivity
• History of over 6 months of opioid dependency prior to surgery (excluding tramadol)
• Peripheral neuropathy
• Mental/cognitive impairment that would interfere with the patient's self-assessments of function, pain, or quality of life

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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100 participants in 2 patient groups

Psoas Compartment Block

Experimental group

Description:

After exposure anesthetic (Ropivacaine with NaCl) is introduced directly into the iliopsoas muscle, where it then spreads to the lumbar plexus (the nerves responsible for sensation around the surgical site).

Treatment:

Drug: Ropivacaine with NaCl

Periarticular Local Anesthetic

Active Comparator group

Description:

An anesthetic "cocktail" of four drugs (ropivacaine, epinephrine, ketorolac tromethamine, morphine) is injected at five locations at the surgical site to the surrounding tissues.

Treatment:

Drug: Ropivacaine

Drug: Morphine

Drug: Epinephrine

Drug: Ketorolac Tromethamine