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Patients undergoing total hip arthroplasty are randomly assigned to two groups (fascia iliaca compartement block [FICB] group or quadratus lumborum block [QLB] group). In the FICB group, ultrasound-guided suprainguinal FICB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is performed on the ipsilateral surgical side at the end of surgery. In the QLB group, ultrasound-guided anterior QLB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery. A standardized multimodal analgesic regimen is used for postoperative pain control. The total use of opioids including patient-controlled analgesia and rescue analgesics is compared in both groups for 24 hours after surgery. The amount of opioids used is compared by conversion to oral morphine equivalent dose. Pain score at rest and movement during postoperative 24 hours, time to first request for analgesics, the incidence of side effects, patient satisfaction for pain control at postoperative 24 hours, quality of recovery at postoperative 24 hours, time to discharge readiness, and hospital length of stay are compared.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| fascia iliaca compartement block [FICB] group | Experimental |
| |
| quadratus lumborum block [QLB] group | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| fascia iliaca compartement block | Procedure | Ultrasound-guided suprainguinal FICB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Total opioids use for 24 hours | Total dose of opioids used upto 24 hours after surgery (morphine milligram equivalents) | Over the first 24 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain at rest (Numeric rating scale) | Postoperative pain at rest (Numeric rating scale; minimum 0, maximum 10, a higher score means more pain) | At postoperative 4, 8, 12, 16, 20, 24 hours |
| Postoperative pain with movement (Numeric rating scale) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Seokha Yoo, M.D. | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | 03080 | South Korea |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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|
| quadratus lumborum block | Procedure | Ultrasound-guided anterior QLB (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery. |
|
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Postoperative pain with movement (Numeric rating scale; minimum 0, maximum 10, a higher score means more pain) |
| At postoperative 4, 8, 12, 16, 20, 24 hours |
| Time to first request for pain medication | Time to first request for pain medication after surgery | From the end of surgery to discharge, an average of 4 days |
| Incidence of postoperative nausea and vomiting | Incidence of postoperative nausea and vomiting (%) | Over the first 24 hours after surgery |
| Patient satisfaction score with pain control at 24 hours after surgery | Patient satisfaction score with pain control at 24 hours after surgery (minimum 0, maximum 10, a higher score means higher satisfaction) | At 24 hours after surgery |
| Quality of Recovery at 24 hours after surgery | Quality of Recovery at 24 hours after surgery assessed by QoR-15 questionnaire | At 24 hours after surgery |
| Time to discharge readiness | Days of hospitalization after surgery until discharge readiness (defined as satisfying the following three criteria; (1) adequate pain control (numeric rating scale score < 4), (2) no intravenous opioid use in the past 12 hours, and (3) able to walk at least 30 m without time limit) | From the end of surgery to discharge, an average of 4 days |
| Hospital length of stay | Days of hospitalization after surgery until discharge | From the end of surgery to discharge, an average of 4 days |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |