Ultrasound Guided Quadratus Lumborum Block for Post Operative Analgesia After Hip Arthroplasty

Alexandria University

Status: Unknown

Conditions: Pain, Postoperative

Treatments: Procedure: Anterior Quadratus lamborum block

Study type: Interventional

Funder types: Other

Identifiers

NCT03502369

050108004

Details and patient eligibility

About

The study evaluates the effectiveness of anterior quadratus lumborum block for post operative analgesia after hip arthroplasty. Half of the participants will receive ultrasound guided anterior quadratus lumborum block using 30ml bupivacaine 0.375%, while the other half will not receive the block ( control group).

Full description

Sensory innervation of the hip region involves branches of the lumbar plexus and sacral plexus. Effective post operative analgesia can be approached by blocking the lumbar plexus at the level of the quadratus lumborum muscle. Quadratus lumborum block has several approach methods (anterior, lateral, posterior, and intramuscular). Anterior quadratus lumborum block also known as transmuscular QL block or QL3, the local anaesthetic (30ml of bupivacaine 0.375%) is injected between the psoas major muscle (PM) and the quadratus lumborum muscle (QL). Therefore, the anterior quadratus lumborum block may generate analgesia from T10 to L4 covering the sensory innervation of the hip region.

Enrollment: 90 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American society of anesthesiologists physical status |-||| , scheduled to undergo unilateral hip replacement via lateral approach.

Exclusion criteria

• patient refusal.
• History of neurological/neuromuscular, psychiatric, dementia preventing proper comprehension.
• coagulation disorders.
• History of allergy to the study medication.
• Infection overlying the injection site.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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90 participants in 2 patient groups

QL group

Experimental group

Description:

Anterior Quadratus lumborum block will be done for all patients of these group. Local anaesthetic (30ml of bupivacaine) will be injected in fascial plane between the quadratus lumborum muscle and Psoas major muscle by using the ultrasound.

Treatment:

Procedure: Anterior Quadratus lamborum block

C group

No Intervention group

Description:

Patients of these group will be the control group. The will receive acetaminophen 1g every 8h, ketorolac 30mg ever 12h and as required morphine 2mg for post operative analgesia after hip arthroplasty.