Using spinal anesthesia at the L5-S1 space for hip and knee replacement surgeries
The Anesthetic and Recovery Profiles of Low-dose Hypobaric Bupivacaine in Spinal Anesthesia Injected in the L5-S1 Space for Total Hip and Knee Arthroplasty
This study tests whether using spinal anesthesia in a specific part of the lower back can help older patients having hip or knee replacement surgeries feel less pain and recover faster.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 55 (estimated) |
| Ages | 20 Years and up |
| Sex | All |
| Sponsor | University Health Network, Toronto Academic / other |
| Locations | 1 site (Toronto, Ontario) |
| Trial ID | NCT06526156 on ClinicalTrials.gov |
What this trial studies
This observational study focuses on patients undergoing elective total hip or knee arthroplasty who will receive spinal anesthesia at the L5-S1 intervertebral space. The study aims to evaluate the effectiveness of this approach, particularly in patients with age-related spinal conditions that complicate traditional anesthesia methods. By administering a higher dose of bupivacaine, the study seeks to determine if adequate sensory loss can be achieved without prolonging recovery times. The goal is to improve patient outcomes and streamline the discharge process following surgery.
Who should consider this trial
Good fit: Ideal candidates are adults aged 20 and older undergoing elective unilateral total hip or knee arthroplasty under spinal anesthesia.
Not a fit: Patients with contraindications to spinal anesthesia, significant obesity, or previous spinal surgeries may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could lead to more effective pain management during surgery and quicker recovery times for patients.
How similar studies have performed: While the approach of using the L5-S1 space for spinal anesthesia is less common, similar studies have explored alternative anesthesia techniques, though this specific method remains relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients undergoing elective unilateral total hip or knee arthroplasty under spinal anesthesia at TWH who are scheduled for inpatient overnight admission * American Society of Anesthesiologists physical status class (ASA-PS) 1-3 * At least 20 years of age Exclusion Criteria: * Refusal to participate * Inability to communicate due to language barrier or cognitive impairment * Height \> 200 cm * Weight \>120 kg * Body mass index (BMI) \>45 kg/m\^2 * Contraindication or allergy to amide-type local anesthetic * Contraindication to spinal anesthesia at the L5-S1 space (e.g., infection at the injection site, existing coagulopathy, severe spinal stenosis at higher vertebral levels) * Previous spinal surgery in the lumbosacral spine * Spinal anesthesia performed in the operating room rather than the block room * Spinal anesthesia that includes administration of intrathecal opioids (e.g., morphine, fentanyl) * Pre-existing sensory or motor impairment in the lower extremities * Inability to identify the L5-S1 space with ultrasonography
Where this trial is running
Toronto, Ontario
- Toronto Western Hospital — Toronto, Ontario, Canada (Recruiting)
Study contacts
- Principal investigator: Ki Jinn Chin, MBBS,MMed,FRCPC — Uhn
- Study coordinator: Jayanta Chowdhury, MBBS,MD
- Email: jayanta.chowdhury@uhn.ca
- Phone: 416-603-5800
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.