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This prospective randomized controlled trial evaluates the effect of ultrasound-guided unilateral Femoral Rami and Obturator Nerve Trunk (FRONT) block on postoperative quality of recovery in patients undergoing elective total hip arthroplasty.
Total hip arthroplasty (THA) is associated with significant postoperative pain that may impair early recovery. The Femoral Rami and Obturator Nerve Trunk (FRONT) block is a regional anesthesia technique targeting sensory innervation of the anterior hip capsule and may improve postoperative recovery while preserving motor function. This prospective randomized controlled trial aims to evaluate whether the addition of ultrasound-guided unilateral FRONT block to standard multimodal analgesia improves postoperative quality of recovery in patients undergoing THA.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FRONT Block Group | Experimental | Participants in this group will receive an ultrasound-guided unilateral Femoral Rami and Obturator Nerve Trunk (FRONT) block in addition to standardized multimodal postoperative analgesia. |
|
| Control Group | Active Comparator | Participants in this group will receive standardized multimodal postoperative analgesia without FRONT block. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FRONT Block (Femoral Rami and Obturator Nerve Trunk Block) | Procedure | Ultrasound-guided unilateral FRONT block targeting the femoral rami and obturator nerve trunk will be performed |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Quality of Recovery (QoR-15 Score) | Postoperative quality of recovery will be assessed using the validated Quality of Recovery-15 (QoR-15) questionnaire. The total score ranges from 0 to 150, with higher scores indicating better recovery. | 24 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of Recovery (QoR-15) Score at 48 Hours | Quality of recovery will be assessed using the validated Quality of Recovery-15 (QoR-15) questionnaire (0-150, higher scores indicate better recovery). | 48 hours after surgery |
| Postoperative Pain Intensity |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Betul Kozanhan | Recruiting | Konya | 42005 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D015207 | Osteoarthritis, Hip |
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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Participants will be randomized in a 1:1 ratio to receive either an ultrasound-guided unilateral FRONT block plus standard multimodal analgesia or standard multimodal analgesia alone. Outcomes will be compared between the two parallel groups.
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Outcome assessments will be performed by independent researchers blinded to group allocation.
| Standard Multimodal Analgesia | Procedure | Standardized postoperative multimodal analgesia including intravenous paracetamol, nonsteroidal anti-inflammatory drugs, and rescue opioid analgesia as required. |
|
Pain intensity will be assessed using an 11-point Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. |
| 2, 6, 12, 24, and 48 hours after surgery |
| Total Opioid Consumption | Total postoperative opioid consumption during the first 24 hours will be recorded and converted to intravenous morphine milligram equivalents (MME). | 0-24 hours after surgery |
| Time to First Rescue Analgesia | Time from the end of surgery to the first rescue opioid administration will be recorded | Within the first 24 hours after surgery |
| Time to First Mobilization | Time from the end of surgery to first assisted ambulation will be recorded | Within the first 48 hours after surgery |
| Quadriceps Motor Strength | Quadriceps muscle strength will be evaluated using the Medical Research Council (MRC) scale ranging from 0 (no contraction) to 5 (normal muscle strength). | 0-48 hours after surgery |
| D012216 |
| Rheumatic Diseases |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |