Psoas sheath block versus suprainguinal fascia iliaca block for pain after hip replacement

Evaluating the Efficacy of the Psoas Sheath Block for Post Operative Analgesia Following Hip Arthroplasty

This trial will test whether a psoas sheath block provides better pain relief than a suprainguinal fascia iliaca plane block for adults having elective total hip replacement.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 130 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University College Hospital Galway (Academic / other)
• Locations: 1 site (Galway)
• Trial ID: NCT07453498 on ClinicalTrials.gov

What this trial studies

This single-centre, assessor-blind, randomized controlled trial at Merlin Park Hospital, Galway will compare two regional anaesthesia techniques for postoperative analgesia after elective unilateral total hip arthroplasty. Participants will be randomly assigned to receive either a psoas sheath block (experimental) or a suprainguinal fascia iliaca plane block (control) with allocation concealed in opaque sealed envelopes. The outcome assessor will be blinded to group allocation and common outcomes will include postoperative pain scores and opioid consumption. The trial focuses on adults (ASA I-III) willing to receive regional blocks and provide informed consent.

Who should consider this trial

Good fit: Adults over 18 scheduled for elective unilateral total hip replacement who are ASA I-III, willing to receive regional anaesthesia, and able to provide informed consent are eligible.

Not a fit: Patients with allergy to study medications, chronic high-dose opioid use, active infection at the injection site, coagulopathy or on anticoagulants, or neurological conditions affecting the lower limbs are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, the psoas sheath block could provide better pain control and reduce opioid use after hip replacement, potentially improving recovery and mobility.

How similar studies have performed: Regional blocks such as fascia iliaca and psoas compartment techniques have been shown to reduce pain and opioid need after hip surgery, but direct comparisons between psoas sheath and suprainguinal fascia iliaca blocks are limited.

Eligibility criteria

Inclusion Criteria:

* Participants aged \>18
* Patients scheduled to undergo elective unilateral total hip replacement (THR) surgery.
* Patients who agree to receive regional anaesthetic blocks as part of their post-operative pain management.
* Physical Status: ASA (American Society of Anesthesiologists) physical status classification I-III.
* Patients who are willing and able to provide informed consent, demonstrating an understanding of the trial's purpose, methods, and potential risks.
* Patients who are willing to comply with assessments post-surgery

Exclusion Criteria:

* Allergy to Study Medications
* History of chronic opioid use (\>50mg of oral morphine equivalents per day.
* Any neurological condition affecting the lower extremities (e.g., peripheral neuropathy, radiculopathy) that could interfere with pain assessment or recovery evaluation.
* Infection at Injection Site
* Coagulopathy or Anticoagulant Use: Patients with coagulopathy (INR \>1.5) or who are on anticoagulant therapy that cannot be safely discontinued for the block procedure.
* Severe Respiratory or Cardiovascular Disease: Any severe respiratory or cardiovascular disease (e.g., severe chronic obstructive pulmonary disease, heart failure) that may increase perioperative risk and complicate recovery.
* Cognitive impairment or conditions (e.g., dementia with MMSE \<24) that would prevent reliable pain reporting or compliance with post-operative assessments

Where this trial is running

Galway

• Merlin Park Hospital, Galway — Galway, Ireland (Recruiting)

Study contacts

• Study coordinator: Anna L Horgan, MC BCh BAO FCAI

Conditions Total Hip Arthroplasty; Psoas Sheath Block; Regional anaesthesia