Lumbar Plexus Block Versus Quadratus Lumborum Block for Primary Anterior Total Hip Arthroplasty
Osteoarthritis, Total Hip Arthroplasty
About this trial
This is an interventional supportive care trial for Osteoarthritis focused on measuring Lumbar Plexus Block, Quadratus Lumborum Block, Direct Anterior Approach, Post-Operative, Pain Management
Eligibility Criteria
Inclusion Criteria:
- Any patient between the ages of 18 and 95 years undergoing a primary elective, unilateral DAA total hip arthroplasty.
Exclusion Criteria:
- If the patient uses more than 40mg of Oxycodone equivalents per 24 hours or is on extended release opioid formulations.
- Indication for surgery is secondary to trauma and/or hip fracture
- If there is a contraindication to the performance of a regional block
- Concomitant anticoagulation use or documented coagulopathy
- Infectious or dermatologic conditions in the area of block placement that would otherwise increase the risk of peripheral nerve blockade
- Presence of progressive neurologic deficit effecting peripheral nerves
- Allergy or adverse reaction to study drugs to include: fentanyl, epinephrine, and amide local anesthetics
- American Society of Anesthesia Physical Classification score > or = to 4
- Allergies to study drugs other than local anesthetic
- BMI > 40
- Patient refusal
- Pregnancy
- Institutionalized individuals
- Extremes of age: Age > 95 or < 18
- Non English speaking or inability to reliably participate in the study
Sites / Locations
- Wake Forest Baptist Medical Center
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
LPB Unilateral DAA THA
QLB Unilateral DAA THA
Patients will be randomized to receive either a LPB or QLB for post-operative analgesia. Randomization to either LPB or QLB will occur via block randomization using sealed sequentially numbered opaque envelopes that will correspond to the order with which patients are enrolled. Patients and research assistants will be blinded to their randomization by administration of intravenous sedation (titrated to patient comfort), utilization of ultrasonography to visualize pertinent structures for both blocks, and by the nature of the block technique themselves both being in close proximity on the posterior lower back.
Patients will be randomized to receive either a LPB or QLB for post-operative analgesia. Randomization to either LPB or QLB will occur via block randomization using sealed sequentially numbered opaque envelopes that will correspond to the order with which patients are enrolled. Patients and research assistants will be blinded to their randomization by administration of intravenous sedation (titrated to patient comfort), utilization of ultrasonography to visualize pertinent structures for both blocks, and by the nature of the block technique themselves both being in close proximity on the posterior lower back.