Fascia Iliaca Compartment Block For Analgesia After Total Hip Arthroplasty

NCT ID: NCT01758497

Last Updated: 2016-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-10-31

Study Completion Date

2011-08-31

Brief Summary

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Introduction Fascia Iliaca compartment block (FICB) is commonly used to treat pain in patients after total hip arthroplasty (THA) despite the lack of RCTs to evaluate the efficacy of FICB for this indication. Therefore the objective of this study was to assess the analgesic benefit of FICB for post-operative pain management in THA.

Methods After IRB approval and informed consent, patients having THA at our center in the period 2010-2011 were recruited. Eligible patients were adults, ASA physical status I-III, and BMI \<30) with no contraindication to study procedures. In the PACU, all patients received morphine sulfate IVPCA; patients reporting pain \> 3 on the NRS-11 despite IVPCA were randomized by the method of sealed envelopes to receive US guided injections of 30ml 0.5% ropivacaine (FICB) or 30ml 0.9% NaCl (sham block, SB) beneath the fascia iliaca.

The primary outcome variable was opioid analgesic consumption during the first 24 h postoperatively. Secondary outcome measures were pain intensity (NRS-11) and extent of sensory blockade.

Detailed Description

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Introduction Fascia Iliaca compartment block (FICB) is commonly used to treat pain in patients after total hip arthroplasty (THA) despite the lack of RCTs to evaluate the efficacy of FICB for this indication. Therefore the objective of this randomized, prospective trial was to assess the analgesic benefit of FICB for post-operative pain management in THA. Our hypothesis was that FICB would confer an analgesic benefit for patients after THA.

Methods After IRB approval and informed consent, patients having THA at our center in the period 2010-2011 were recruited in the morning of their surgery. Eligible patients were adults, ASA physical status I-III, and BMI \<30) with no contraindication to study procedures. In the PACU, all patients received morphine sulfate IVPCA; patients reporting pain \> 3 on the NRS-11 despite IVPCA were randomized by the method of sealed envelopes to receive US guided injections of 30ml 0.5% ropivacaine (FICB) or 30ml 0.9% NaCl (sham block, SB) beneath the fascia iliaca.

The primary outcome variable was opioid analgesic consumption during the first 24 h postoperatively. Secondary outcome measures were pain intensity (NRS-11) and extent of sensory blockade.

Conditions

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Pain Disorder Sensory Deficit

Keywords

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Fascia Iliaca compartment block, Pain, Sensorial blockade

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Ropivacaine

US guided injections of 30 ml 0.5% ropivacaine (Fascia Iliaca Compartment Block)

Group Type ACTIVE_COMPARATOR

Fascia iliaca compartment block

Intervention Type PROCEDURE

30 ml 0.5% ropivacaine, beneath the fascia iliaca

Saline

US guided injections of 30 ml 0.9% NaCl (Fascia Iliaca Compartment Block)

Group Type SHAM_COMPARATOR

Fascia Iliaca compartment block

Intervention Type PROCEDURE

30 ml 0.9% NaCl (sham block, SB), beneath the fascia iliaca

Interventions

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Fascia iliaca compartment block

30 ml 0.5% ropivacaine, beneath the fascia iliaca

Intervention Type PROCEDURE

Fascia Iliaca compartment block

30 ml 0.9% NaCl (sham block, SB), beneath the fascia iliaca

Intervention Type PROCEDURE

Other Intervention Names

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Ultrasound guided Fascia iliaca compartment block FICB Ultrasound guided Fascia iliaca compartment block FICB

Eligibility Criteria

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Inclusion Criteria

* Adults
* ASA physical status I-III
* BMI\<30
* No contraindications to study procedures

Exclusion Criteria

* Pediatric patients
* ASA physical status IV
* BMI\>30
* Contraindications to study procedures
* Hypersensitivity to local anesthetics
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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St. Luke's-Roosevelt Hospital Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Admir Hadzic, MD,PhD

Role: STUDY_DIRECTOR

St. Luke's-Roosevelt Hospital Center

Locations

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St Luke's Roosevelt Hospitals

New York, New York, United States

Site Status

Countries

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United States

References

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Dalens B, Vanneuville G, Tanguy A. Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesth Analg. 1989 Dec;69(6):705-13.

Reference Type RESULT
PMID: 2589650 (View on PubMed)

Dolan J, Williams A, Murney E, Smith M, Kenny GN. Ultrasound guided fascia iliaca block: a comparison with the loss of resistance technique. Reg Anesth Pain Med. 2008 Nov-Dec;33(6):526-31. doi: 10.1016/j.rapm.2008.03.008.

Reference Type RESULT
PMID: 19258967 (View on PubMed)

Weller RS. Does fascia iliaca block result in obturator block? Reg Anesth Pain Med. 2009 Sep-Oct;34(5):524; author reply 524. doi: 10.1097/AAP.0b013e3181ada59f. No abstract available.

Reference Type RESULT
PMID: 19749590 (View on PubMed)

Foss NB, Kristensen BB, Bundgaard M, Bak M, Heiring C, Virkelyst C, Hougaard S, Kehlet H. Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. Anesthesiology. 2007 Apr;106(4):773-8. doi: 10.1097/01.anes.0000264764.56544.d2.

Reference Type RESULT
PMID: 17413915 (View on PubMed)

Stevens M, Harrison G, McGrail M. A modified fascia iliaca compartment block has significant morphine-sparing effect after total hip arthroplasty. Anaesth Intensive Care. 2007 Dec;35(6):949-52. doi: 10.1177/0310057X0703500615.

Reference Type RESULT
PMID: 18084988 (View on PubMed)

Goitia Arrola L, Telletxea S, Martinez Bourio R, Arizaga Maguregui A, Aguirre Larracoechea U. [Fascia iliaca compartment block for analgesia following total hip replacement surgery]. Rev Esp Anestesiol Reanim. 2009 Jun-Jul;56(6):343-8. doi: 10.1016/s0034-9356(09)70406-2. Spanish.

Reference Type RESULT
PMID: 19725341 (View on PubMed)

Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: Comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. a prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004 Mar-Apr;29(2):102-9. doi: 10.1016/j.rapm.2003.11.006.

Reference Type RESULT
PMID: 15029544 (View on PubMed)

Other Identifiers

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09-042

Identifier Type: -

Identifier Source: org_study_id