Using low concentration local anesthesia for pain relief after hip replacement surgery

Low Concentration Local Anesthesia Fascia Iliaca Block for Total Hip Arthroplasty

This study is testing whether a lower concentration of local anesthesia can help manage pain better after hip replacement surgery without causing muscle weakness compared to a higher concentration.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 60 (estimated)
• Ages: 21 Years and up
• Sex: All
• Sponsor: University of Toronto (other)
• Locations: 1 site (Toronto, Ontario)
• Trial ID: NCT06102811 on ClinicalTrials.gov

What this trial studies

This clinical trial investigates the efficacy of low concentration local anesthetic fascia iliaca block (LCLA-FICB) compared to high concentration local anesthetic fascia iliaca block (HCLA-FICB) for postoperative pain management in patients undergoing total hip arthroplasty (THA). The study aims to evaluate pain scores and opioid consumption in the first 24 hours post-surgery, while also assessing the impact on quadriceps muscle strength. By utilizing a randomized controlled design, the trial seeks to determine if LCLA-FICB can provide effective analgesia without the motor weakness associated with traditional methods. The findings could lead to improved recovery protocols and reduced healthcare costs for THA patients.

Who should consider this trial

Good fit: Ideal candidates include non-pregnant adults over 21 undergoing primary total hip arthroplasty in an inpatient setting.

Not a fit: Patients undergoing outpatient hip replacement or those with chronic opioid use may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could enhance pain management for hip replacement patients while minimizing motor weakness and opioid use.

How similar studies have performed: While there are no published trials specifically on LCLA-FICB for THA, similar techniques have shown promise in other surgical contexts.

Eligibility criteria

Inclusion Criteria:

* 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 Criteria:

* 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.

Where this trial is running

Toronto, Ontario

• Mount Sinai Hospital — Toronto, Ontario, Canada (RECRUITING)

Study contacts

• Principal investigator: Hermann dos Santos Fernandes, MD, PhD — University of Toronto
• Study coordinator: Hermann dos Santos Fernandes, MD, PhD

Conditions: Arthroplasty, Replacement, Hip