A Prospective Analysis of Preoperative Fascia Iliaca Block for Hip Arthroscopy
| Status: | Completed |
|---|---|
| Conditions: | Chronic Pain, Neurology |
| Therapuetic Areas: | Musculoskeletal, Neurology |
| Healthy: | No |
| Age Range: | 18 - 99 |
| Updated: | 12/29/2018 |
| Start Date: | February 2015 |
| End Date: | September 2017 |
Patients undergoing arthroscopic hip surgery have been shown to have significant
post-operative pain that may delay discharge, recovery, and early mobilisation. A
pre-operative regional anesthesia technique, the fascia iliaca block may be an effective
method for acute post-operative analgesia.
This is a prospective, randomized controlled study of the preoperative fascia iliaca block
for patients undergoing hip arthroscopy.
The enrolled patients will be randomized to receive either a fascia iliaca block with the
local anesthetic ropivacaine or to have a sham block. All patients will receive a general
anesthetic for the hip arthroscopy.
post-operative pain that may delay discharge, recovery, and early mobilisation. A
pre-operative regional anesthesia technique, the fascia iliaca block may be an effective
method for acute post-operative analgesia.
This is a prospective, randomized controlled study of the preoperative fascia iliaca block
for patients undergoing hip arthroscopy.
The enrolled patients will be randomized to receive either a fascia iliaca block with the
local anesthetic ropivacaine or to have a sham block. All patients will receive a general
anesthetic for the hip arthroscopy.
Arthroscopic hip surgery is used to diagnose and treat interior joint pathology. Although
minimally invasive in nature, patients have considerable amount of pain postoperatively,
leading to prolonged recovery room stay and increased opiate requirements. The investigators
performed a retrospective chart review in patients who underwent hip arthroscopy at the UCSF
Orthopedic Institute. 89% of the patients had pain immediate after surgery requiring opioid
therapy. Regional anesthesia has previously been shown to reduce discomfort after hip
arthroscopy. However, there is currently no safe, well-established ultrasound guided regional
anesthesia technique for arthroscopic hip surgery. The fascia iliaca block has shown to
decrease acute pain related with hip fractures, as well as pain related with knee
arthroplasty. The ultrasound guided fascia iliaca block is easy to perform and has an
excellent safety record. The investigators believe that the ultrasound guided fascia iliaca
block improves pain control in patients undergoing arthroscopic hip surgery.
Patients will receive a sham block group or a fascia iliaca block, performed in the
preoperative area.
Pain scores and measurement of quadriceps strength will be assessed preoperatively and
postoperatively. The patient will receive a pain diary consisting of pain scores, pain
medication consumption, and a brief pain inventory. Within 48 hours postoperatively, an
anesthesiologist will call the patient and review the patient's pain scores, pain medication
consumption and brief pain inventory.
minimally invasive in nature, patients have considerable amount of pain postoperatively,
leading to prolonged recovery room stay and increased opiate requirements. The investigators
performed a retrospective chart review in patients who underwent hip arthroscopy at the UCSF
Orthopedic Institute. 89% of the patients had pain immediate after surgery requiring opioid
therapy. Regional anesthesia has previously been shown to reduce discomfort after hip
arthroscopy. However, there is currently no safe, well-established ultrasound guided regional
anesthesia technique for arthroscopic hip surgery. The fascia iliaca block has shown to
decrease acute pain related with hip fractures, as well as pain related with knee
arthroplasty. The ultrasound guided fascia iliaca block is easy to perform and has an
excellent safety record. The investigators believe that the ultrasound guided fascia iliaca
block improves pain control in patients undergoing arthroscopic hip surgery.
Patients will receive a sham block group or a fascia iliaca block, performed in the
preoperative area.
Pain scores and measurement of quadriceps strength will be assessed preoperatively and
postoperatively. The patient will receive a pain diary consisting of pain scores, pain
medication consumption, and a brief pain inventory. Within 48 hours postoperatively, an
anesthesiologist will call the patient and review the patient's pain scores, pain medication
consumption and brief pain inventory.
Inclusion Criteria:
- Age at least 18 years old
- American Society of Anesthesia physical classification I - III, scheduled for
arthroscopic hip surgery
Exclusion Criteria:
- Age younger than 18 years old
- Non-English speaking
- Contraindicated for regional nerve block (such as, but not limited to: coagulopathy,
infection at site, allergy to local anesthetic)
- Preexisting neurologic deficits of operative limb
- Need for postoperative nerve function test
- Inability to consent due to cognitive dysfunction
- Chronic pain
- Patient refusal.
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