Preoperative Fluoroscopy Guided Hip Articular Branch Blocks and Analgesic Outcomes Following Hip Arthroscopy
NCT ID: NCT04538105
Last Updated: 2021-09-16
Study Results
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Basic Information
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WITHDRAWN
NA
INTERVENTIONAL
2021-05-01
2022-10-01
Brief Summary
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This current study aims to evaluate the efficacy of using preoperative fluoroscopic-guided blockade of articular branches of the femoral and obturator nerves for analgesic management of patients undergoing arthroscopy compared to a saline sham block.
The utility of pre-operative hip articular branch block (ABB) prior to hip arthroscopy will provide superior pain management postoperatively compared to a saline sham block. We hypothesize that the ABB (Articular Branch Block) will reduce the area under the NRS pain scores by time curve (AUC) and decreased oral opioid milligram equivalent use in the first 24 hours post-operatively.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Sham Injection
20cc of Normal Saline 0.9%
Control
Saline Articular Nerve Branch Block
Articular Branch Block (ABB)
20cc of 0.5% Bupivacaine with epinephrine 1:200,000
Articular Branch Block (ABB)
0.5% Bupivacaine with epinephrine 1:200,000 (Articular Branch Block)
Interventions
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Control
Saline Articular Nerve Branch Block
Articular Branch Block (ABB)
0.5% Bupivacaine with epinephrine 1:200,000 (Articular Branch Block)
Eligibility Criteria
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Inclusion Criteria
* Pre-operative Numeric Rating Score (NRS) for pain \<8 on a 0 to 10 scale where 0 is no pain and 10 is worst pain imaginable.
Exclusion Criteria
* Anti-coagulation status (INR \> 1.1, PT or APTT \> 1.5 control)
* History of Hip Arthroplasty
* Infection of Hip
* Evidence of tumor
* Pregnancy
* History of diabetes with HbA1c \> 10%
* Prior history of Hip Articular Branch Blockade or Hip Articular Branch PRF Ablation
18 Years
75 Years
ALL
Yes
Sponsors
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Rush University Medical Center
OTHER
Responsible Party
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Tolga Suvar, MD
Principle Investigator
References
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Colvin AC, Harrast J, Harner C. Trends in hip arthroscopy. J Bone Joint Surg Am. 2012 Feb 15;94(4):e23. doi: 10.2106/JBJS.J.01886.
Yu HC, Al-Shehri M, Johnston KD, Endersby R, Baghirzada L. Anesthesia for hip arthroscopy: a narrative review. Can J Anaesth. 2016 Nov;63(11):1277-90. doi: 10.1007/s12630-016-0718-7. Epub 2016 Aug 16.
Steinhaus ME, Rosneck J, Ahmad CS, Lynch TS. Outcomes After Peripheral Nerve Block in Hip Arthroscopy. Am J Orthop (Belle Mead NJ). 2018 Jun;47(6). doi: 10.12788/ajo.2018.0049.
GARDNER E. The innervation of the hip joint. Anat Rec. 1948 Jul;101(3):353-71. doi: 10.1002/ar.1091010309. No abstract available.
Aprato A, Giachino M, Masse A. Arthroscopic approach and anatomy of the hip. Muscles Ligaments Tendons J. 2016 Dec 21;6(3):309-316. doi: 10.11138/mltj/2016.6.3.309. eCollection 2016 Jul-Sep.
Byrd JW. Hip arthroscopy. J Am Acad Orthop Surg. 2006 Jul;14(7):433-44. doi: 10.5435/00124635-200607000-00006. No abstract available.
Philippi MT, Kahn TL, Adeyemi TF, Maak TG, Aoki SK. Extracapsular local infiltration analgesia in hip arthroscopy patients: a randomized, prospective study. J Hip Preserv Surg. 2018 Sep 18;5(3):226-232. doi: 10.1093/jhps/hny030. eCollection 2018 Aug.
Kay J, de Sa D, Memon M, Simunovic N, Paul J, Ayeni OR. Examining the Role of Perioperative Nerve Blocks in Hip Arthroscopy: A Systematic Review. Arthroscopy. 2016 Apr;32(4):704-15.e1. doi: 10.1016/j.arthro.2015.12.022. Epub 2016 Feb 20.
Kapural L, Jolly S, Mantoan J, Badhey H, Ptacek T. Cooled Radiofrequency Neurotomy of the Articular Sensory Branches of the Obturator and Femoral Nerves - Combined Approach Using Fluoroscopy and Ultrasound Guidance: Technical Report, and Observational Study on Safety and Efficacy. Pain Physician. 2018 May;21(3):279-284.
Nye ZB, Horn JL, Crittenden W, Abrahams MS, Aziz MF. Ambulatory continuous posterior lumbar plexus blocks following hip arthroscopy: a review of 213 cases. J Clin Anesth. 2013 Jun;25(4):268-74. doi: 10.1016/j.jclinane.2012.11.013. Epub 2013 May 9.
Dold AP, Murnaghan L, Xing J, Abdallah FW, Brull R, Whelan DB. Preoperative femoral nerve block in hip arthroscopic surgery: a retrospective review of 108 consecutive cases. Am J Sports Med. 2014 Jan;42(1):144-9. doi: 10.1177/0363546513510392. Epub 2013 Nov 27.
Krych AJ, Baran S, Kuzma SA, Smith HM, Johnson RL, Levy BA. Utility of multimodal analgesia with fascia iliaca blockade for acute pain management following hip arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2014 Apr;22(4):843-7. doi: 10.1007/s00167-013-2665-y. Epub 2013 Sep 24.
Lee EM, Murphy KP, Ben-David B. Postoperative analgesia for hip arthroscopy: combined L1 and L2 paravertebral blocks. J Clin Anesth. 2008 Sep;20(6):462-5. doi: 10.1016/j.jclinane.2008.04.012.
Keller S, Bann CM, Dodd SL, Schein J, Mendoza TR, Cleeland CS. Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain. 2004 Sep-Oct;20(5):309-18. doi: 10.1097/00002508-200409000-00005.
Stark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013 Jun;118(6):1332-40. doi: 10.1097/ALN.0b013e318289b84b.
Griffin DR, Parsons N, Mohtadi NG, Safran MR; Multicenter Arthroscopy of the Hip Outcomes Research Network. A short version of the International Hip Outcome Tool (iHOT-12) for use in routine clinical practice. Arthroscopy. 2012 May;28(5):611-6; quiz 616-8. doi: 10.1016/j.arthro.2012.02.027.
YaDeau JT, Tedore T, Goytizolo EA, Kim DH, Green DS, Westrick A, Fan R, Rade MC, Ranawat AS, Coleman SH, Kelly BT. Lumbar plexus blockade reduces pain after hip arthroscopy: a prospective randomized controlled trial. Anesth Analg. 2012 Oct;115(4):968-72. doi: 10.1213/ANE.0b013e318265bacd. Epub 2012 Jul 19.
Other Identifiers
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20051404
Identifier Type: -
Identifier Source: org_study_id
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