Ultrasound-Guided Quadro-Iliac Plane Block for Pain Management After Total Hip Arthroplasty

Bursa City Hospital

Status: Enrolling

Conditions: Total Hip Arthroplasty; Pain Management

Treatments: Procedure: Sham Block; Procedure: Quadro-Iliac Plane (QIP) Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07410000

Bursa City Hospital 14

Details and patient eligibility

About

This prospective, randomized, double-blind study evaluates the analgesic effectiveness of the ultrasound-guided Quadro-Iliac Plane (QIP) block in patients undergoing primary total hip arthroplasty. The QIP block is a recently described fascial plane block. Patients will be randomized to receive either a QIP block with local anesthetic or a sham block with saline. The primary outcome is 24-hour opioid consumption. Secondary outcomes include motor block, dermatomal sensory assessment, pain scores, rescue analgesic requirement, quality of recovery (QoR-15), and opioid-related side effects.

Full description

Total hip arthroplasty is associated with significant postoperative pain. The Quadro-Iliac Plane (QIP) block is a recently described fascial plane block targeting the area where the quadratus lumborum muscle attaches to the iliac crest and may provide more comprehensive analgesia. This study is designed as a prospective, randomized, double-blind clinical trial including patients aged 18-80 years with ASA physical status I-III undergoing elective primary total hip arthroplasty.

Patients will be randomized into two groups. The QIP group will receive an ultrasound-guided QIP block with 40 mL of 0.25% local anesthetic solution containing epinephrine, and the control group will receive a sham block with 40 mL of 0.9% NaCl using the same technique. The primary outcome is postoperative 24-hour opioid consumption. Secondary outcomes include motor block, and dermatomal sensory assessment, pain scores, quality of recovery (QoR-15), rescue analgesic requirement and opioid-related side effects

Enrollment: 100 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists (ASA) classification I-III
• Age between 18 and 80 years
• Patients scheduled for elective primary total hip arthroplasty

Exclusion criteria

• Refusal to participate in the study
• Allergy to local anesthetics or opioids
• Known or suspected coagulopathy
• Infection at the injection site
• History of previous hip surgery
• Severe cardiovascular disease
• Liver or kidney failure
• Pregnancy, suspected pregnancy, or breastfeeding
• Severe neurological or psychiatric disorder
• Chronic opioid use

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

---

100 participants in 2 patient groups, including a placebo group

Quadro-Iliac Plane (QIP) Block

Experimental group

Description:

Participants in this arm will receive the standard analgesia protocol used for patients undergoing total hip arthroplasty. In addition to this standard regimen, an ultrasound-guided Quadro-Iliac Plane (QIP) block will be performed in the preoperative period with the patient in the lateral decubitus position. The technique aims to provide postoperative analgesia by achieving sensory blockade in the relevant dermatomal areas.

Treatment:

Procedure: Quadro-Iliac Plane (QIP) Block

Sham Block (Control)

Placebo Comparator group

Description:

Participants in this arm will receive the standard analgesia protocol used for patients undergoing total hip arthroplasty. In addition to this standard regimen, a sham block will be performed using the same ultrasound-guided technique and patient positioning to mimic the block procedure without providing active regional anesthesia.

Treatment:

Procedure: Sham Block