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This study aims to compare lumbar erector spinae plane block, fascia iliaca block, and lumbar plexus block for postoperative analgesia for hip surgery.
Approximately 500,000 hip arthroplasties are performed each year in the United States. Traditionally, this procedure has been performed under general anesthesia. However, neuraxial and regional anesthesia have become more commonly utilized to aid in postoperative analgesia and reduce the side effects of opioids, namely sedation, nausea, and vomiting. Postoperative pain control has a significant impact on earlier ambulation, initiation of physical therapy, better functional recovery, and overall patient satisfaction.
Lumbar erector spinae plane block (LESPB) was reported to lead to effective postoperative analgesia in hip and proximal femoral surgery.
The fascia iliaca block (FIB) is an established and effective technique, especially when US guidance and proximal approaches are used.
lumbar plexus block (LPB) could be safe because of the targeted somatic nerve block in the psoas region which prevents dispensable sympathetic block even in cardiovascular-compromised patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lumbar Erector Spinae Plane Block | Experimental | Patients will receive lumbar erector spinae plane block at the end of surgery. |
|
| Fascia Iliaca Block | Experimental | Patients will receive fascia iliaca block at the end of surgery. |
|
| Lumbar Plexus Block | Experimental | Patients will receive lumbar plexus block at the end of surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lumbar Erector Spinae Plane Block | Other | Patients will receive lumbar erector spinae plane block at the end of surgery. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to the 1st rescue analgesia | Time to the first request for the rescue analgesia (time from end of block to first dose of morphine administrated) will be recorded. | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption in the 1st 24h | Rescue analgesia will be provided by patient-controlled analgesia (PCA) with intravenous morphine (no basal rate; bolus 1 mg, lockout 10 minutes, maximum dose 20 mg in 4 h), which will be started if the numeric rating scale (NRS)> 3. NRS will be assessed at PACU, 4, 8, 16, and 24 h postoperatively. | 24 hours postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Tanta | El-Gharbia | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Fascia Iliaca Block | Other | Patients will receive fascia iliaca block at the end of surgery. |
|
| Lumbar Plexus Block | Other | Patients will receive lumbar plexus block at the end of surgery. |
|
| Degree of pain | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at PACU, 4, 8, 16, and 24 h postoperatively. | 24 hours postoperatively |
| Incidence of adverse events | Incidence of adverse events such as Bradycardia, hypotension, postoperative nausea and vomiting (PONV), or any other complication will be recorded. | 24 hours postoperatively |
| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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