Quadratus Lumborum Block for Total Hip Arthroplasty
Status:
Recruiting
Trial end date:
2024-02-01
Target enrollment:
Participant gender:
Summary
The quadratus lumborum (QL) block is a fascial plane block primarily used to provide pain
relief in abdominal surgeries. Most literature on the QL block focuses on pain control after
lower abdominal, urologic (urinary tract system) or gynecologic (reproductive system)
surgeries, however, its pain relief coverage has been described as wide as T7-L3 dermatomes
(pain relief that extends from the lower chest to the knee) and as such, may prove applicable
in lower extremity surgeries such as the total hip arthroplasty (THA, a surgical procedure
performed to restore function of the hip joint). Further investigation regarding the efficacy
of QL blocks in patients undergoing primary THA under spinal anesthesia (a procedure that
numbs from the waist down) would be of value, particularly as there is a push towards
opioid-sparing analgesia (pain relief that minimizes the use of opiates) and reducing
hospital length of stay, something that can be minimized with better patient pain control
after surgery. The investigators aim to evaluate the efficacy of ultrasound guided QL nerve
blocks as a method of analgesia (pain relief) for patients undergoing primary THA.
Patients will be randomized to receive a QL nerve block with either saline or ropivacaine (a
local anesthetic) prior to their surgical procedure. The QL nerve block procedure will take
between 3 and 10 minutes of the patient's time. During this procedure the patient will be
made comfortable either with local anesthetic medication or IV anti-anxiety medications.
During the QL nerve block procedure patients will be asked to receive an injection that is
placed on the side of their abdomen, between layers of their flank muscles. The injection is
placed using the guidance of an ultrasound machine.
Postoperative outcomes assessed will include: pain score, amount of opioid pain medications
taken, distance of first ambulation (walking without assistance), length of hospital stay,
and patient satisfaction. Outcomes will be assessed at 3hrs, 12hrs, 24hrs, and 48hrs after
the surgical procedure ends and will be assessed by a combination of medical record review
and by survey. Patients will be surveyed by phone call or in-person visit to the patient's
room. Each assessment encounter should take between 1 and 5 minutes.
Participants will be involved in the study through the 48 hour follow-up period and total
time required from patients will range from 7 minutes to 30 minutes.