RecruitingNot ApplicableNCT06102811

Low Concentration Local Anesthesia Fascia Iliaca Block for Total Hip Arthroplasty

Sponsor

University of Toronto

Enrollment

60 participants

Start Date

Oct 23, 2023

Study Type

INTERVENTIONAL

Conditions

Arthroplasty, Replacement, Hip

Summary

Fascia iliaca compartment block (FICB) is a documented option for postoperative analgesia for total hip arthroplasty (THA) surgery. FICB is demonstrated to be effective in terms of analgesia and opioid requirements decrease, however it causes quadriceps motor weakness. Current available motor sparing techniques are not as effective as FICB for analgesia. Low concentration local anesthetics (LCLA) are used with excellent results for pain control with no or minimum motor block effect, in other scenarios (highlighted in obstetric anesthesia) and techniques (epidural anesthesia, for instance). This study proposes that LCLA-FICB can offer the benefit of peripheral nerve blocks mediated analgesia, while at the same time avoiding motor blockade and muscle weakness. The investigators hypothesize that LCLA-FICB, when compared to conventional high concentration local anesthetics (HCLA) FICB, provides similar postoperative analgesia in the first 24 hours following primary THA, while at the same time preserving quadriceps muscle group strength.

Eligibility

Min Age: 21 Years

Inclusion Criteria4

Patients undergoing primary THA in the inpatient setting.
Non-pregnant patients older than 21 years of age.
Patients with American Society of Anesthesiologists (ASA) physical status I-IV.
No alcohol or drug dependency.

Exclusion Criteria6

Patients undergoing outpatient THA.
Chronic opioid use of 30 mg or more of oral morphine equivalent, per day, for the last 2 consecutive weeks.
Contraindications for nerve block placement (severe anatomic abnormalities, local or systemic infection).
Contraindications for any of the standardized medications used for the study (Mepivacaine, Fentanyl, Dexamethasone, Ondansetron, Acetaminophen, Celecoxib, Hydromorphone).
Not submitted to the standardized spinal anesthesia technique.
Need to conversion to general anesthesia after the start of the surgery.

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