Ultrasound-Guided Quadro-Iliac Plane Block for Pain Management After Total Hip Arthroplasty
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Quadro-Iliac Plane (QIP) Block, Sham Block.
- Who it may be relevant to
- Registry conditions: Pain Management, Total Hip Arthroplasty. Basic parameters: 18 years — 80 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Turkey (Türkiye)
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effectiveness of Ultrasound-Guided Quadro-Iliac Plane Block for Pain Management After Total Hip Arthroplasty: A Prospective Randomized Study
Overview
This prospective, randomized, double-blind study evaluates the analgesic effectiveness of the ultrasound-guided Quadro-Iliac Plane (QIP) block in patients undergoing primary total hip arthroplasty. The QIP block is a recently described fascial plane block. Patients will be randomized to receive either a QIP block with local anesthetic or a sham block with saline. The primary outcome is 24-hour opioid consumption. Secondary outcomes include motor block, dermatomal sensory assessment, pain scores, rescue analgesic requirement, quality of recovery (QoR-15), and opioid-related side effects.
Detailed description
Total hip arthroplasty is associated with significant postoperative pain. The Quadro-Iliac Plane (QIP) block is a recently described fascial plane block targeting the area where the quadratus lumborum muscle attaches to the iliac crest and may provide more comprehensive analgesia. This study is designed as a prospective, randomized, double-blind clinical trial including patients aged 18-80 years with ASA physical status I-III undergoing elective primary total hip arthroplasty.
Patients will be randomized into two groups. The QIP group will receive an ultrasound-guided QIP block with 40 mL of 0.25% local anesthetic solution containing epinephrine, and the control group will receive a sham block with 40 mL of 0.9% NaCl using the same technique. The primary outcome is postoperative 24-hour opioid consumption. Secondary outcomes include motor block, and dermatomal sensory assessment, pain scores, quality of recovery (QoR-15), rescue analgesic requirement and opioid-related side effects
Interventions
- Procedure Quadro-Iliac Plane (QIP) Block
An ultrasound-guided Quadro-Iliac Plane block performed in the preoperative period. At the level of the iliac crest, 40 mL of a solution containing 0.25% levobupivacaine and 5 µg/mL epinephrine is injected into the fascial plane between the erector spinae muscle and the quadratus lumborum muscle under aseptic conditions. - Procedure Sham Block
A sham block performed using the same ultrasound-guided technique in the preoperative period. At the level of the iliac crest, 40 mL of 0.9% NaCl is injected into the fascial plane between the erector spinae muscle and the quadratus lumborum muscle under aseptic conditions.
Primary outcome measures
- Postoperative 24-Hour Morphine PCA Consumption [Time frame: Postoperative 24 hours]
Secondary outcome measures (5)
- NRS Pain Scores at Rest and Movement [Time frame: 2, 6, 12, 24, and 48 hours postoperatively]
- QoR-15 Recovery Score [Time frame: QoR-15 Recovery Score will be evaluated at the postoperative 48th hour]
- Lower Extremity Muscle Strength Score [Time frame: Postoperative 6th and 12th hours]
- Rescue Analgesic Requirement [Time frame: Postoperative 0-48 hours]
- Opioid-Related Side Effects [Time frame: Postoperative 0-48 hours]
Eligibility criteria
Inclusion criteria
- American Society of Anesthesiologists (ASA) classification I-III
- Age between 18 and 80 years
- Patients scheduled for elective primary total hip arthroplasty
Exclusion criteria
- Refusal to participate in the study
- Allergy to local anesthetics or opioids
- Known or suspected coagulopathy
- Infection at the injection site
- History of previous hip surgery
- Severe cardiovascular disease
- Liver or kidney failure
- Pregnancy, suspected pregnancy, or breastfeeding
- Severe neurological or psychiatric disorder
- Chronic opioid use
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Quadruple blind
- Primary purpose
- Treatment
Study locations
Turkey (Türkiye) · 1 center
- Bursa City Hospital — Bursa
Publications
- Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017 Sep 25;10:2287-2298. doi: 10.2147/JPR.S144066. eCollection 2017. PMID 29026331
- Carella M, Beck F, Piette N, Denys S, Kurth W, Lecoq JP, Bonhomme VL. Effect of suprainguinal fascia iliaca compartment block on postoperative opioid consumption and functional recovery in posterolateral-approached total hip arthroplasty: a single-blind randomized controlled trial. Reg Anesth Pain Med. 2022 Jun 15:rapm-2021-103427. doi: 10.1136/rapm-2021-103427. Online ahead of print. PMID 35705263
- Marrone F, Sorrentino T, Pullano C, Tulgar S. A novel and feasible option for perioperative analgesia in hip fractures surgery: quadro-iliac plane block. Minerva Anestesiol. 2025 Jun;91(6):592-595. doi: 10.23736/S0375-9393.25.18801-9. Epub 2025 Mar 27. No abstract available. PMID 40145906
- Tulgar S, Ciftci B, Ahiskalioglu A, Bilal B, Sakul BU, Girit M, Akin T, Narayanan M, Alici HA. Ultrasound guided quadro-iliac plane block: another novel fascial plane block. Pain Med. 2024 May 3;25(6):370-373. doi: 10.1093/pm/pnae018. PMID 38459608
- Selvi O, Azizoglu M, Temel G, Tulgar S, Chitneni A, Cinar EN, Ozer Z, Gurkan Y. Translation and Validation of the Turkish Version of the Quality of Postoperative Recovery Score QoR-15: A Multi-Centred Cohort Study. Turk J Anaesthesiol Reanim. 2022 Dec;50(6):443-448. doi: 10.5152/TJAR.2022.21417. PMID 36511494
Identifiers
NCT: NCT07410000 · Bursa City Hospital 14