Ultrasound Guided Fascia Iliaca Block for Pain Control After Elective Hip Replacement Surgery
NCT ID: NCT02108847
Last Updated: 2016-11-15
Study Results
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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COMPLETED
NA
42 participants
INTERVENTIONAL
2014-04-30
2015-04-30
Brief Summary
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Detailed Description
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Sensory innervation of the hip joint comes from a combination of peripheral nerves, including femoral, obturator, sciatic, superior gluteal, and nerve for the quadratus femoris muscle. Superficial innervation of the skin involved in incision for hip arthroplasty comes from the lateral femoral cutaneous nerve (LFCN).
The fascia iliaca block (FIB) was originally described in 1989 using a landmark technique. The ultrasound guided FIB was introduced in recent years, and has been shown to produce a better quality of block than the landmark technique. It appears to consistently block the femoral and LFCN, while being less successful in achieving consistent obturator blockade.
The FIB is effective for analgesia for hip fracture injuries in the emergency department. Thus far, there has been limited exploration into the potential use of this block as a tool for postoperative analgesia after elective hip arthroplasty. The potential benefits of this regional block, as with other regional techniques, include better analgesia, less opioid use and associated side effects, and an improved overall patient satisfaction with postoperative recovery.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
QUADRUPLE
Study Groups
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Fascia Iliaca Block - Ropivacaine
Ultrasound guided fascia iliaca block performed preoperatively with 40 mL of 0.2% ropivacaine.
.2% Ropivacaine
Fascia Iliaca Block
Ultrasound-guided regional anesthesia block to the groin area.
Fascia Iliaca Block - Saline
Ultrasound guided fascia iliaca block performed preoperatively with 40 mL of Saline.
Saline
Fascia Iliaca Block
Ultrasound-guided regional anesthesia block to the groin area.
Interventions
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.2% Ropivacaine
Saline
Fascia Iliaca Block
Ultrasound-guided regional anesthesia block to the groin area.
Eligibility Criteria
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Inclusion Criteria
* Scheduled for elective total hip arthroplasty
Exclusion Criteria
* Neurologic disorder affecting the ability to sense pain
* Long term opioid use or chronic pain disorder
* History of drug or alcohol abuse
* Patient refusal
* Pregnancy
* Revision procedures
* General anesthetic
* Psychiatric or mental conditions that may affect assessment of outcomes
18 Years
99 Years
ALL
No
Sponsors
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Saskatoon Health Region
OTHER
University of Saskatchewan
OTHER
Responsible Party
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Jacelyn Larson
M.D.
Principal Investigators
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Jacelyn Larson, MD
Role: PRINCIPAL_INVESTIGATOR
University of Saskatchewan
Locations
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Saskatoon City Hospital
Saskatoon, Saskatchewan, Canada
Countries
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References
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Chelly JE, Ben-David B, Williams BA, Kentor ML. Anesthesia and postoperative analgesia: outcomes following orthopedic surgery. Orthopedics. 2003 Aug;26(8 Suppl):s865-71. doi: 10.3928/0147-7447-20030802-08.
Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003 Aug;97(2):534-540. doi: 10.1213/01.ANE.0000068822.10113.9E.
Birnbaum K, Prescher A, Hessler S, Heller KD. The sensory innervation of the hip joint--an anatomical study. Surg Radiol Anat. 1997;19(6):371-5. doi: 10.1007/BF01628504.
Mitchell ME. Regional anesthesia for hip surgery. Techniques in Regional Anesthesia and Pain Management 3(2): 94-106, 1999.
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.
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.
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.
Godoy Monzon D, Iserson KV, Vazquez JA. Single fascia iliaca compartment block for post-hip fracture pain relief. J Emerg Med. 2007 Apr;32(3):257-62. doi: 10.1016/j.jemermed.2006.08.011. Epub 2007 Feb 8.
Other Identifiers
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Bio 13-314
Identifier Type: -
Identifier Source: org_study_id