Comparison Between 2 Techniques for Lumbar-ESPB
Regional Anesthesia in Hip Arthroplasty- Comparison Between Two Techniques for Erector Spinae Plane Block
Papa Giovanni XXIII Hospital
44 participants
Oct 6, 2025
INTERVENTIONAL
Conditions
Summary
Diffusion of local anesthetics after a lumbar ESPB within fascial planes towards nerve structures is a matter of debate. The main objective of the study is to compare the incidence of sensory block between two techniques of needle placement (superficial or translaminar) during lumbar ESPB block. Patients are treated with lumbar ESPB (randomized to superficial or translaminar), spinal anesthesia and multimodal analgesia. The primary endpoint will be the incidence of numbness/reduced skin sensitivity to cold (ice test) in the area innervated by the lumbar plexus. Secondary outcomes are pain and analgesic's consumption, motor block, quality of recovery and discharge ability.
Eligibility
Inclusion Criteria2
- primary total hip replacement
- informed consent
Exclusion Criteria10
- allergies to study drugs
- spinal anesthesia contraindicated
- kidney failure (GFR<30)
- epilepsy, psychiatric disease, neurologic deficits
- revision surgery
- neuropathies in the lumbar area (tingling, hypoestesia, numbness, motor deficit)
- no informed consent
- pregnancy
- alcohol/opioid abuse
- emergency surgery/intensive care
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Interventions
spinal anesthesia at L3-L4 plain bupivacaine 0.5% 2.2 ml
Lidocaine 1% + ropivacaine 0.25% 30 ml with adrenaline 1:200.000 on top of L3 transverse process, between bone and erector spinae muscle
Lidocaine 1% + ropivacaine 0.25% 30 ml with adrenaline 1:200.000 between L3 and L4 transverse process, between erector spinae muscle and deep muscles
8 mg iv preoperatively
preoperatively and postoperatively (every 8 hours)
1000 mg preoperatively and postoperatively (every 8 hours)
Patient Controlled Analgesia
Locations(1)
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NCT07104097