Quadratus Lumborum Type 2 as Chronic Hip Pain Treatment

Overview

The main objective of the study is to assess whether the performance of type 2 quadratus lumborum block produces an improvement in the quality of life of the patient with osteoarthritis of the hip.

Study Type

• Study Type: Observational
• Study Design
  • Time Perspective: Prospective
• Study Primary Completion Date: September 1, 2022

Detailed Description

The lumbar square block is an interfascial block of the posterior wall of the abdomen, initially described for the management of postoperative pain in abdominal surgery due to its suggested effect on the T7-11 roots. The analgesic efficacy of type 1 lumbar square block (QL1) in hip surgery was subsequently published. Regarding chronic pain, QL2 has been successfully performed in posttherniorrhaphy pain or pancreatic cancer. This quadratus lumborum type 2 is performed in the patients with hip joint based on the innervation of the hip and taking the role of thoraco-lumbar fascia in the analgesia of these patients as a reference. The good results obtained in the first 5 patients have led us to evaluate whether this blockade can indeed be an analgesic alternative in patients with coxarthrosis.

Interventions

• Drug: levobupivacaine
  • local anesthetic
• Device: ultrasound device
  • scream

Arms, Groups and Cohorts

• quadratus lumborum
  • analgesic technique. The evaluation of the patient will consist of 2 stages. The first of these will consist of the evaluation consultation (clinical history, EVN evaluation, WOMAC) and initial treatment (QL2 block). In the second stage, the patient will be followed up with interviews at 3 weeks, 3 and 6 months.
• Control
  • Current analgesia , no QL block apply

Clinical Trial Outcome Measures

Primary Measures

• relieve chronic hip pain
  • Time Frame: 2 months
  • The main objective of the study is to assess whether the performance of type 2 lumbar .square block produces an improvement in the quality of life of the patient with osteoarthritis of the hip. The evaluation of the patient will consist of 2 stages. The first of these will consist of the evaluation consultation evaluation with verbal numeric scale (VNS: 0 no dolor-10 the worst pain imaginable ) if patients improve their quality of pain

Secondary Measures

• rate of adverse effects of the block
  • Time Frame: 2 months
  • find if there is complications (hematome, kidney punction…)

Participating in This Clinical Trial

Inclusion Criteria

• Sign informed consent (Annex 2) – Age 18-85 years – Cartilage injury (coxarthrosis) hip – Illness <1 year of evolution – Patients with pain after treatment with physical therapy, exercises, NSAIDs. – EVN> 5 Exclusion Criteria:

• Refusal of the patient – Allergy to the drugs used – Contraindication for performing the technique – Intraarticular treatment in the previous 3 months – Pregnancy

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 85 Years

Are Healthy Volunteers Accepted: No

Investigator Details

• Lead Sponsor
  • Hospital Medina del Campo
• Collaborator
  • Hospital Universitaio Getafe
• Provider of Information About this Clinical Study
  • Principal Investigator: María Teresa Fernandez, Principal Investigator – Hospital del Río Hortega
• Overall Official(s)
  • Maria Teresa Fernandez, Study Chair, Hospital Medina del Campo
• Overall Contact(s)
  • Maria Teresa T Fernandez, 637571685, maitefm70@hotmail.com

References

Adhikary SD, Short AJ, El-Boghdadly K, Abdelmalak MJ, Chin KJ. Transmuscular quadratus lumborum versus lumbar plexus block for total hip arthroplasty: A retrospective propensity score matched cohort study. J Anaesthesiol Clin Pharmacol. 2018 Jul-Sep;34(3):372-378. doi: 10.4103/joacp.JOACP_335_17.

Adhikary SD, El-Boghdadly K, Nasralah Z, Sarwani N, Nixon AM, Chin KJ. A radiologic and anatomic assessment of injectate spread following transmuscular quadratus lumborum block in cadavers. Anaesthesia. 2017 Jan;72(1):73-79. doi: 10.1111/anae.13647. Epub 2016 Oct 12.

Fernandez Martin MT, Lopez Alvarez S, Ortigosa Solorzano E. Quadratus lumborum block. New approach for a chronic hip pain. Cases report. Rev Esp Anestesiol Reanim (Engl Ed). 2020 Jan;67(1):44-48. doi: 10.1016/j.redar.2019.10.001. Epub 2019 Nov 22. English, Spanish.