Use of Regional Anesthesia in Hip Arthroscopy

NCT ID: NCT02851888

Last Updated: 2018-02-19

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-07-31

Study Completion Date

2018-08-31

Brief Summary

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The purpose of this research is to determine differences in outcomes in patients who do, or do not, receive regional anesthesia (a fascia iliaca block) prior to undergoing hip arthroscopy with labral repair and/or debridement and osteoplasty for hip impingement

Detailed Description

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Patients undergoing hip arthroscopy for hip impingement at the investigator's institution often have regional anesthesia (a nerve block) prior to the procedure to help prevent and/or reduce pain following the procedure. The investigators are interested in determining benefits as well as potential adverse effects of utilizing regional anesthesia in patients undergoing hip arthroscopy for impingement. To do so, they plan to enroll patients aged 18-50 undergoing hip arthroscopy, and randomize them to one of two groups with one group receiving regional anesthesia pre-operatively and the second control group, that does not. The surgical procedure and the post-operative management will be the same for both groups.

Regional anesthesia prior to orthopaedic procedures has been widely adopted in many fields of orthopaedics. While it is generally considered safe and an excellent adjuvant for pain control, there have been few studies exploring outcomes beyond pain control. In many centers, the use of regional anesthesia in hip arthroscopy is reserved for post-operative management of pain. There are multiple studies indicating that patients receiving regional anesthesia (a fascia iliaca or femoral nerve block) had significantly greater improvements in pain score and even an excellent alternative to routine narcotic medication in patients undergoing hip arthroscopy. Other orthopaedic procedures, such as knee arthroscopy, utilize similar techniques to achieve post-operative pain control through a femoral-sciatic nerve block.

There have also been studies looking at the utilization of regional anesthesia via lumbar plexus blocks with hip arthroscopy. One study found that patients undergoing hip arthroscopy with higher levels of preoperative psychological distress frequently utilized a lumbar plexus block to achieve adequate pain control. Other studies found that lumbar plexus blocks significantly improved pain while in the PACU. While serious complications of lumbar plexus block were rare, minor complications such as falls, persistent paresthesias, and unexpected admissions do occur. At our institution, we do not utilize lumbar plexus blocks for regional anesthesia in patients undergoing hip arthroscopy. Rather, our standard of care is to have an anesthesiologist perform a single shot fascia iliaca block using ropivicaine while the patient is in the pre-operative holding bay.

To the investigative team's knowledge, there are no studies comparing the difference in pain control, as well as the differences in narcotic requirements in PACU, duration of stay in PACU, reported falls, unplanned admissions and/or readmissions, Harris hip score and nerve pain/paresthesias/numbness in patients who have undergone hip arthroscopy with and without regional anesthesia. A better understanding of pain and functional outcomes following hip arthroscopy with and without regional anesthesia can help providers better assess circumstances when regional anesthesia can be beneficial or detrimental to a patient's post-operative course.

Conditions

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Hip Injuries

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Iliac Fascia Block (Ropivacaine)

These patients will receive a preoperative iliac fascia block performed as a single shot in the standard fashion prior to hip arthroscopy with general anesthesia.

Group Type EXPERIMENTAL

Ropivacaine

Intervention Type DRUG

Iliac fascia block was performed in the experimental group with a single shot of Ropavicaine.

General Anesthesia

Intervention Type PROCEDURE

Patients were induced and maintained in a fashion consistent with standard practices.

Control (Normal Saline Sham Injection)

These patients will receive a preoperative sham block of normal saline in the same fashion as a standard singl shot iliac fascia block prior to hip arthroscopy with general anesthesia.

Group Type SHAM_COMPARATOR

Normal Saline Sham Injection

Intervention Type OTHER

Sham block using normal saline instead of iliac fascia block but otherwise employing the equivalent technique.

General Anesthesia

Intervention Type PROCEDURE

Patients were induced and maintained in a fashion consistent with standard practices.

Interventions

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Ropivacaine

Iliac fascia block was performed in the experimental group with a single shot of Ropavicaine.

Intervention Type DRUG

Normal Saline Sham Injection

Sham block using normal saline instead of iliac fascia block but otherwise employing the equivalent technique.

Intervention Type OTHER

General Anesthesia

Patients were induced and maintained in a fashion consistent with standard practices.

Intervention Type PROCEDURE

Other Intervention Names

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Iliac Fascia Block

Eligibility Criteria

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Inclusion Criteria

* Scheduled for arthroscopic labral repair with or without osteoplasty of the hip.
* 18 to 50 years old
* American Society of Anesthesiologists Physical Status (ASA PS) score of I or II.

Exclusion Criteria

* Current or planned pregnancy
* History of neuropathic pain, chronic pain syndrome, or preoperative use of narcotic or neuropathic pain medicine
* Radiographic signs of osteoarthritis (\> Tonis grade 1)
* Inability to attend follow up visits
* Documented allergy to local anesthetic
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Union Memorial Hospital

OTHER

Sponsor Role collaborator

Georgetown University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Blake Bodendorfer, MD

Role: PRINCIPAL_INVESTIGATOR

Georgetown University

Locations

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Georgetown University Medical Center

Washington D.C., District of Columbia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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John G Mawn, BS

Role: CONTACT

2624883210

Jessica B Hawken, BA

Role: CONTACT

7039949605

Facility Contacts

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John Mawn, BS

Role: primary

262-488-3210

Other Identifiers

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2016-0095

Identifier Type: -

Identifier Source: org_study_id

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