QLESP Block Versus Periarticular Infiltration for Postoperative Analgesia in Hip Surgery

Huazhong University of Science and Technology

Status: Enrolling

Conditions: Regional Anaesthesia

Treatments: Drug: ropivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT06688136

WHUH20241101

Details and patient eligibility

About

Local and/or regional analgesia techniques are critical components of an optimal multimodal analgesia technique, as they have been shown to improve pain relief as well as reduce opioid requirements. Optimal pain management technique balances pain relief with concerns about safety and adverse effects associated with analgesic techniques. Periarticular infiltration (PAI) is increasingly included as a component of multimodal analgesia technique for patients undergoing THA, as it provides improved postoperative pain relief with no effects on quadriceps function. Recently, our group has developed a novel transmuscular quadratus lumborum and modified erector spinae plane (QLESP) block, which is characterized by simple operation, high efficiency, and wide dermatomal coverage of sensory block. Therefore, we designed a randomized controlled trial to compare ultrasound-guided QLESP with PAI as a component of non-opioid analgesic regimen in patients undergoing THA via posterior approach. We hypothesized that QLESP would provide superior analgesia when compared with PAI. The primary outcome of the study was postoperative opioid requirements within the initial 24-h postoperative period after THA. The secondary objectives were to compare pain scores, postoperative quadriceps strength, the time to first rescue analgesia, opioid-related adverse effects, time to ambulation, and the time to hospital discharge.

Enrollment: 80 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age 18-65 yrs
2. American Society of Anesthesiologists classification 1-3
3. Body mass index between 20 and 35 (kg/m2)
4. Undergo elective primary unilateral THA via a posterolateral approach
5. Informed consent

Exclusion criteria

1. A known allergy to the drugs being used
2. Pre-existing neuropsychiatric disorders or language barrier
3. Analgesics intake, history of substance abuse
4. Contraindications to peripheral nerve block
5. Acute cerebrovascular disease
6. Severe liver failure

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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80 participants in 2 patient groups

transmuscular quadratus lumborum and modified erector spinae plane (QLESP) block

Experimental group

Description:

Twenty ml of 0.4% ropivacaine was administered between the erector spinae muscle and the transverse process. Twenty ml of 0.4% ropivacaine was subsequently given between the quadratus lumborum and the psoas major muscles.

Treatment:

Drug: ropivacaine

Infiltration

Active Comparator group

Description:

Periarticular infiltration of 40 ml of 0.4% ropivacaine prior to closing the incision

Treatment:

Drug: ropivacaine