Lumbar erector spinae plane block to reduce pain after total hip replacement
Ultrasound-Guided Lumbal Erector Spinae Plane Block on Postoperative Pain Management After Total Hip Arthroplasty
This trial will test whether a lumbar erector spinae plane block given after anesthesia lowers opioid use and pain for adults having a primary total hip replacement.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 60 (estimated) |
| Ages | 18 Years to 85 Years |
| Sex | All |
| Sponsor | University Tunis El Manar Academic / other |
| Locations | 1 site (Manouba) |
| Trial ID | NCT07240961 on ClinicalTrials.gov |
What this trial studies
This is a prospective, randomized trial comparing an ultrasound-guided lumbar erector spinae plane block (ESPB) plus standard multimodal analgesia versus standard multimodal analgesia alone in adults undergoing primary total hip arthroplasty under general anesthesia. After induction, participants randomized to the ESPB group receive a single-shot lumbar ESP block (30 mL of 0.25% bupivacaine or 0.2% ropivacaine) placed at the L4 transverse process under ultrasound guidance, while the control group receives no block. All patients receive the same postoperative regimen including IV then oral paracetamol, oral diclofenac, and PCA morphine for rescue; patients are observed in a continuous care unit for 24 hours. The primary outcome is opioid consumption in the first 24 postoperative hours, with secondary outcomes including measures of pain and recovery.
Who should consider this trial
Good fit: Adults over 18 years old, ASA I-III, scheduled for a primary unilateral total hip arthroplasty via a lateral approach under general anesthesia and meeting the study's weight and renal function criteria are ideal candidates.
Not a fit: Patients with contraindications to regional anesthesia or NSAIDs, allergies to opioids or paracetamol, creatinine clearance below 30 mL/min, weight under 50 kg or over 100 kg, psychiatric or communication difficulties, lower limb neurological deficits, or those having bilateral or revision hip replacement are unlikely to be eligible or to benefit.
Why it matters
Potential benefit: If successful, the block could reduce opioid use and improve postoperative pain control after hip replacement, potentially lowering opioid-related side effects.
How similar studies have performed: Small case series and some reports in the literature suggest lumbar ESPB can provide effective analgesia after hip surgery, but randomized data remain limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * primary total hip arthroplasty with lateral approach and under general anesthesia . Exclusion Criteria: * • Contraindication or refusal to regional anesthesia * Contraindication to non-steroidal anti-inflammatory (NSAID's) * Allergy to opioids * Allergy to paracetamol * Creatinine clearance \< 30ml/min * Weight\<50 kg or \>100kg * Psychiatric disorders and difficulty of communication * Lower limb neurological deficit * Patients undergoing bilateral or revision total hip replacement
Where this trial is running
Manouba
- Kassab Orthopedic Institute — Manouba, Tunisia (Recruiting)
Study contacts
- Study coordinator: Kaabachi Olfa
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.