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QIPB vs SI-FICB for Postoperative Analgesia After Total Hip Arthroplasty

ConditionsHip OsteoarthritisTotal Hip Arthroplasty (THA)Postoperative PainAcute Pain
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-75
SponsorDokuz Eylul University

About this trial

Total hip arthroplasty (THA) causes moderate-to-severe postoperative pain. The PROSPECT guideline recommends the supra-inguinal fascia iliaca compartment block (SI-FICB) for THA, whereas evidence for newer quadratus-lumborum-family blocks is limited. The quadro-iliac plane block (QIPB) is a recently described fascial plane block, and no study has compared QIPB with SI-FICB head-to-head in any surgical context. In this prospective, double-blind, patients undergoing elective THA who receive one of the two routinely used preoperative blocks (SI-FICB or QIPB, chosen by the attending anesthesiologist as part of routine care) are systematically observed and compared. The primary objective is to assess whether the postoperative analgesic efficacy of QIPB is non-inferior to SI-FICB, using the resting NRS pain score at 6 hours postoperatively as the primary endpoint (non-inferiority margin Δ = 1.3).

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adults aged 18-75 years

Scheduled for elective primary total hip arthroplasty

ASA physical status I-III

Able to understand and communicate in Turkish and complete assessment scales

Disqualifiers

Known allergy/contraindication to any local anesthetic, including bupivacaine

Coagulopathy or anticoagulant/antiplatelet therapy contraindicating block (per ASRA 2022)

Active infection or skin breakdown at the block site

Chronic opioid use (≥3 months daily) or history of opioid dependence

Trial design

Design model

Parallel

Treatments tested in this trial

  • Supra-Inguinal Fascia Iliaca Compartment Block

    Procedure/Surgery

    SIFICB is an ultrasound-guided fascial plane block performed via a supra-inguinal approach to the iliac fascia compartment, targeting the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve. Single-shot, US-guided, 40 mL 0.25% bupivacaine, before GA induction.

  • Quadro-Iliac Plane Block

    Procedure/Surgery

    QIPB is a facial plane block performed under ultrasound guidance with local anesthetic in the interfascial plane between the erector spinae and the quadratus lumborum muscle, at the distal attachment site of the quadratus lumborum muscle on the iliac crest. Single-shot, US-guided, 40 mL 0.25% bupivacaine, before GA induction.

Treatment groups

84 Participants
are divided into 2 treatment groups
Group A: SI-FICBActive comparator 1 intervention
Group B: QIPBExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Pain intensity at rest at 6 hours postoperatively

Numeric Rating Scale (NRS), 0 = no pain to 10 = worst imaginable pain, measured at rest by a blinded assessor. Non-inferiority margin Δ = 1.3 NRS points.

Time frame
6 hours after surgery

Secondary outcomes

1

NRS pain at rest

Time frame
0, 2, 4, 6, 12, 24, 48 hours postoperatively
2

NRS pain on movement (active hip flexion)

Time frame
0, 2, 4, 6, 12, 24, 48 hours postoperatively
3

Cumulative opioid consumption

Time frame
24 hours and 48 hours

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Dokuz Eylul University

Lead sponsor

Source ClinicalTrials.gov

This trial is not recruiting at the moment. You can still explore other options: