The Efficacy of Pain Control After Total Hip Replacement Between Ultrasound Guided Supra-inguinal Fascia Iliaca Block and Intrathecal Morphine

Mahidol University

Status: Unknown

Conditions: Postoperative Pain; Intrathecal Morphine; Total Hip Replacement; Ultrasound Guided Supra-inguinal Fascia Iliaca Block

Treatments: Drug: Intrathecal morphine; Drug: Ultrasound guided supra-inguinal fascia iliaca block

Study type: Interventional

Funder types: Other

Identifiers

NCT04104204

Si 404/2019

Details and patient eligibility

About

Total hip replacement is one of major orthopedic surgery which result in severe postoperative pain especially at first 24 hours. Ultrasound guided regional anesthesia has become a part of multimodal analgesia.Ultrasound guided supra-inguinal fascia iliaca block is a new technique which can consistently cover femoral and lateral femoral cutaneous nerve. And with large volume (40ml), it may cover obturator nerve. This technique already proved to be useful for acute pain control in hip fracture or postoperative control in dynamic hip screw or nail insertion operation. However, it has not been compared with intrathecal morphine for total hip replacement yet.

Full description

By using combine ultrasound guided supra-inguinal fascia iliaca block with periarticular infiltration with mutimodal analgesic drugs will have longer duration time to first rescue analgesic drug compared with combine intrathecal morphine with periarticular infiltration with multimodal analgesic drugs.

Enrollment: 98 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• elective surgery of primary total hip replacement, body weight ≥40kg and BMI ≤35 kg/m2, competence to consent

Exclusion criteria

• contraindication to regional anesthesia, allergy to study drugs, skin infection at supra-inguinal fascia iliaca injection point, neurological deficit affecting the lower extremities, inability to use patient-controlled analgesia, GFR <50 mL/min

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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98 participants in 2 patient groups

Intrathecal morphine

Sham Comparator group

Description:

Intrathecal morphine 0.1 mg, A sham subcutaneous injection of 0.5 ml normal saline at inguinal area

Treatment:

Drug: Intrathecal morphine

Ultrasound guided supra-inguinal fascia iliaca block

Experimental group

Description:

0.25% bupivacaine 40 ml

Treatment:

Drug: Ultrasound guided supra-inguinal fascia iliaca block