Continuous L2 Paravertebral Block Versus Continuous Lumbar Plexus Block for Postoperative Analgesia
This prospective study is intended to compare the analgesic efficacy, preservation of lower extremity motor power and side-effect profile of L2 Paravertebral lumbar plexus approach compared to Posterior nerve stimulation guided lumbar plexus approach, continuous local anesthetic infusion postoperative analgesia of Total Hip Arthroplasty.
The L2 Paravertebral technique of lumbar plexus block, as part of a multimodal pain treatment, could be a cost-effective alternative with a equal profile of analgesic efficacy and motor power sparing with greater promotion of early achievement of postoperative physical therapy goals.
|Total Hip Arthroplasty||Procedure: L2 Paravertebral catheter nerve block Procedure: Continuous Lumbar plexus nerve block|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Continuous L2 Paravertebral Block Versus Continuous Lumbar Plexus Block for Postoperative Analgesia After Total Hip Arthroplasty|
- Postoperative Opiate consumption [ Time Frame: 24 postoperatively ]Postoperative Opiate consumption will be recorded as Morphine IV mg equivalent, for the first 24 hours.
- NRS Pain Score (at rest) [ Time Frame: 24 and 48 hours postoperatively ]Pain scores at Rest will be recorded at 24 and 48 Hours
- NRS Pain Score during physical therapy [ Time Frame: 24 and 48 hours postoperatively ]Pain scores at Rest and During physical therapy will be recorded at 24 and 48 Hours
- TUG (Timed Up and Go) [ Time Frame: 24 hours postoperatively ]The timed get up and go test is a measurement of mobility. It includes a number of tasks such as standing from a seating position, walking, turning, stopping, and sitting down which are all important tasks needed for a person to be independently mobile.
- Straight Leg Raise(SLR) [ Time Frame: 24 hours postoperatively ]In supine position with the extremity being tested and contralateral flexed LE with foot flat on surface. Patient is instructed to lift extremity to level of contralateral knee. Inability to lift entire LE off of the surface to the level of the contralateral knee would be indicative of hip flexor weakness. If the patient is able to lift LE off of the surface, however the knee flexes/unable to maintain full knee extension, this is indicative of quad weakness.
- Long arc quad (LAQ) [ Time Frame: 24 hours postoperatively ]In sitting position at the edge of the bed or chair. Patient is asked to extend lower leg fully on side that is being tested. If able, this is indicative that quad function is intact. If unable to fully extend knee, would indicate quad weakness.
|Study Start Date:||June 2009|
|Study Completion Date:||June 2015|
|Primary Completion Date:||October 2010 (Final data collection date for primary outcome measure)|
Experimental: L2 Paravertebral peripheral nerve block
L2 paravertebral peripheral nerve block catheter will be placed.
Procedure: L2 Paravertebral catheter nerve block
A continuous L2 paravertebral catheter will be placed according to UPMC standard of care practices.
Active Comparator: Continuous Lumbar plexus peripheral nerve block
Continuous unilateral lumbar plexus peripheral nerve block catheter will be placed.
Procedure: Continuous Lumbar plexus nerve block
A continuous unilateral lumbar plexus catheter will be placed according to UPMC standard of care practices.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01571492
|United States, Pennsylvania|
|UPMC Presbyterian Shadyside|
|Pittsburgh, Pennsylvania, United States, 15232|