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

Effectiveness of Ultrasound-Guided Quadro-Iliac Plane Block for Pain Management After Total Hip Arthroplasty: A Prospective Randomized Study

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.

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

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