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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intrathecal morphine | Sham Comparator | Intrathecal morphine 0.1 mg, A sham subcutaneous injection of 0.5 ml normal saline at inguinal area |
|
| Ultrasound guided supra-inguinal fascia iliaca block | Experimental | 0.25% bupivacaine 40 ml |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intrathecal morphine | Drug | 0.5% Iso/Hyperbaric bupivacaine 2-3 ml add morphine 0.1 mg for spinal anesthesia |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to first analgesic request (PCA fentanyl) | Whether ultrasound guided supra-inguinal fascia iliaca block can increase pain free period of patients undergo total hip replacement under spinal block compare with intrathecal morphine or not | 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Pain score | Pain score at rest and on movement rating by numerical rating scale in 48-hr postoperative | 48 hours |
| Amount of rescue analgesic drugs | Amount of PCA fentanyl |
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Pawinee Pangthipampai, M.D. | Contact | +6686 400 1721 | pawinee141@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Pawinee Pangthipampai, M.D. | Siriraj Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Siriraj hospital | Recruiting | Bangkok | 10700 | Thailand |
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| Ultrasound guided supra-inguinal fascia iliaca block | Drug | Ultrasound guided supra-inguinal fascia iliaca block with 0.25% bupivacaine 40 ml and 0.5% Iso/Hyperbaric bupivacaine 2-3 ml without spinal morphine for spinal anesthesia |
|
| 48 hours |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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