LPB Combined with QLB Using Single-needle Technique (LPQLB-SNT) for Hip Arthroplasty

NCT ID: NCT04266236

Last Updated: 2025-02-10

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

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-09

Study Completion Date

2024-06-30

Brief Summary

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Total hip arthroplasty (THA) is one of the most successful orthopedic procedures to effectively relieve pain and restore function in patients with hip osteoarthritis, osteonecrosis of femoral head and hip fracture.The Lumbar Plexus Block (LPB) is currently used as the standard regional anesthesia technique to provide postoperative pain management after THA. The lumbar plexus (LP) originates from T12 to L5. In general, multiple-needle nerve blockade procedure is needed to block different branches of LP. Therefore, we need more time to finish the regional anethesia procedure and it's not easy for an inexperienced anesthesiologist to master the technique absolutely. In addition, multiple injections will increase the discomfort of the patients. We aim to investigate the effects of lumbar plexus combined with quadratus lumborum block using single-needle technique with Shamrock method as an alternative regional anesthesia.

Detailed Description

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Conditions

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Hip Osteoarthritis Anesthesia, Local Hip Fractures Osteonecrosis of Femoral Head

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors

Study Groups

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L3 LPB technique (P group)

ultrasound-guided shamrock approach L3 lumbar plexus block with single-needle technique

Group Type ACTIVE_COMPARATOR

L3 LPB

Intervention Type PROCEDURE

ultrasound-guided L3 lumbar plexus block

0.375%ropivacaine 25 ml (Raropin)

Intervention Type DRUG

0.375%ropivacaine (Raropin) 25ml will be given

General anesthesia with tracheal intubation

Intervention Type PROCEDURE

General anesthesia with tracheal intubation will be induced with sufentanil, propofol, vecuronium for every patient before the operation and maintained with sevoflurane during the operation

T12 combined with L3 and L4 LPB technique (TP group)

ultrasound-guided posterior approach thoracic 12 combined with L3 and L4 lumbar plexus block with mulitple-needle technique

Group Type ACTIVE_COMPARATOR

L3 LPB

Intervention Type PROCEDURE

ultrasound-guided L3 lumbar plexus block

L4 LPB

Intervention Type PROCEDURE

ultrasound-guided L4 lumbar plexus block

T12 block

Intervention Type PROCEDURE

ultrasound-guided thoracic 12th segment nerve block

0.375%ropivacaine 40 ml (Raropin)

Intervention Type DRUG

0.375%ropivacaine (Raropin) 40ml will be given

General anesthesia with tracheal intubation

Intervention Type PROCEDURE

General anesthesia with tracheal intubation will be induced with sufentanil, propofol, vecuronium for every patient before the operation and maintained with sevoflurane during the operation

L3 LPB combined with QLB (LPQLB-SNT, PQ group)

ultrasound-guided shamrock approach L3 lumbar plexus block combined with quadratus lumborum block with single-needle technique

Group Type EXPERIMENTAL

L3 LPB

Intervention Type PROCEDURE

ultrasound-guided L3 lumbar plexus block

L3 QLB

Intervention Type PROCEDURE

ultrasound-guided quadratus lumborum block at L3 level

0.375%ropivacaine 40 ml (Raropin)

Intervention Type DRUG

0.375%ropivacaine (Raropin) 40ml will be given

General anesthesia with tracheal intubation

Intervention Type PROCEDURE

General anesthesia with tracheal intubation will be induced with sufentanil, propofol, vecuronium for every patient before the operation and maintained with sevoflurane during the operation

Interventions

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L3 LPB

ultrasound-guided L3 lumbar plexus block

Intervention Type PROCEDURE

L4 LPB

ultrasound-guided L4 lumbar plexus block

Intervention Type PROCEDURE

T12 block

ultrasound-guided thoracic 12th segment nerve block

Intervention Type PROCEDURE

L3 QLB

ultrasound-guided quadratus lumborum block at L3 level

Intervention Type PROCEDURE

0.375%ropivacaine 25 ml (Raropin)

0.375%ropivacaine (Raropin) 25ml will be given

Intervention Type DRUG

0.375%ropivacaine 40 ml (Raropin)

0.375%ropivacaine (Raropin) 40ml will be given

Intervention Type DRUG

General anesthesia with tracheal intubation

General anesthesia with tracheal intubation will be induced with sufentanil, propofol, vecuronium for every patient before the operation and maintained with sevoflurane during the operation

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Body mass index (BMI) between 18.5 and 30kg/m2 and the weight ≥50kg
2. American Society of Anesthesiologists (ASA) classification I-II
3. Postero-lateral operative incision approach unilateral hip arthroplasty
4. Aged 18-75

Exclusion Criteria

1. Patient refusal
2. Patients with coagulopathy or on therapeutic anticoagulation
3. Pregnancy
4. Multiple trauma
5. Hypersensitivity or allergy to ropivacaine
6. History of ankylosing spondylitis or spinal surgery
7. Lower extremity neuropathy
8. Unable to communicate
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai 6th People's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xiaofeng WANG

Attending doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Shanghai Jiao Tong University Affiliated Sixth People's Hospital

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

References

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Wang X, Zhang H, Chen Y, Xie Z, Chen M, Chen Y, Zhang J. The anesthetic efficacy of ultrasound-guided lumbar plexus combined with quadratus lumborum block with Shamrock approach in total hip arthroplasty: study protocol for a randomized controlled trial. Trials. 2023 Sep 18;24(1):596. doi: 10.1186/s13063-023-07619-z.

Reference Type DERIVED
PMID: 37718446 (View on PubMed)

Other Identifiers

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2020-031

Identifier Type: -

Identifier Source: org_study_id

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