Transmuscular Quadratus Lumborum Block Plus Pericapsular Injection vs Pericapsular Injection

NYU Langone Health

Status and phase: Completed; Phase 4

Conditions: Hip Pain Chronic

Treatments: Procedure: Transmuscular Quadratus Lumborum Block; Drug: Bupivacaine Hydrochloride; Procedure: Pericapsular injection

Study type: Interventional

Funder types: Other

Identifiers

NCT04353414

20-00058

Details and patient eligibility

About

The purpose of this research study is to compare two different treatment options on their effectiveness to reduce post-operative pain, narcotic (opioid pain medication) usage and recovery time in patients undergoing primary hip arthroscopy surgery.

The first treatment option is a Transmuscular Quadratus Lumborum (TQL) block plus hip incision site (Pericapsular) Injection. The TQL block is an ultrasound guided injection between the quadratus lumborum and the psoas muscles in the back. The anesthesiologist will perform the TQL block The second treatment option is only a hip incision site (Pericapsular) Injection. In this group, the surgeon will inject local anesthetic into the incision or hip portal sites to decrease sensation.

Full description

This is a phase IV, randomized, single-blind, single-center study comparing postoperative pain, opioid usage and Post-Anesthesia Care Unit (PACU) recovery time for patients who receive a Transmuscular Quadratus Lumborum block (TQLB) plus pericapsular injection versus pericapsular injection (PCI) undergoing primary hip arthroscopy.

Enrollment: 104 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients between 18 and 65 years of age
• Patients undergoing Primary Hip Arthroscopy
• Patients diagnosed with femoroacetabular impingement (FAI)
• Patients who consent to be randomized.

Exclusion criteria

• Patients younger than 18 and older than 65;
• Patients with a history of chronic pain that have used opioids for pain management for 3 months or longer;
• Patients with diagnosed or self-reported cognitive dysfunction;
• Patients with a history of neurologic disorder that can interfere with pain sensation;
• Patients with a history of drug or recorded alcohol abuse;
• Patients who are unable to understand or follow instructions;
• Patients with severe liver disease, renal insufficiency, congestive heart failure, and/or significant heart disease;
• Patients with an allergy or contraindication to any of the medications used in the study, or patients with a contraindication to any study procedures;
• Patients with BMI over 40;
• Any patient that the investigators feel cannot comply with all study related procedures.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Single Blind

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104 participants in 2 patient groups

Pericapsular Injection (PCI) group

Active Comparator group

Description:

Subjects in PCI group will receive the injection through both hip portals administered by the surgeon. 10 mL of 0.25% Bupivacaine Hydrochloride (HCL) will be injected through the anterolateral portal while the additional 10 mL will be injected through the mid-anterior portal.

Treatment:

Drug: Bupivacaine Hydrochloride

Procedure: Pericapsular injection

Transmuscular QL Block + Pericapsular Injection (PCI) group

Active Comparator group

Description:

Subjects in the TQLB group will receive the TQLB containing 30mL of 0.5% Bupivacaine Hydrochloride (HCL) plus PCI containing 20 mL of 0.25% of Bupivacaine Hydrochloride (HCL). For PCI, subjects will receive the injection through both hip portals administered by the surgeon. 10 mL of 0.25% Bupivacaine Hydrochloride (HCL) will be injected through the anterolateral portal while the additional 10 mL will be injected through the mid-anterior portal.

Treatment:

Procedure: Transmuscular Quadratus Lumborum Block

Drug: Bupivacaine Hydrochloride

Procedure: Pericapsular injection