Quadratus Lumborum vs Erector Spinae Blocks for Postoperative Hip Surgery Pain
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to determine which type of nerve block—erector spinae or quadratus lumborum—better manages pain after hip surgery in children and adolescents. Both blocks accompany a lumbar plexus block to reduce opioid use and enhance pain control. Participants should be aged 15 to 30 with hip issues due to developmental acetabular dysplasia, a condition where the hip socket doesn't fully cover the ball of the thigh bone. As a Phase 4 trial, the treatment is already FDA-approved and proven effective, allowing researchers to understand its benefits for more patients.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. However, if you have been treated with opioids in the last 2 months, you may not be eligible to participate.
What is the safety track record for these treatments?
Research shows that both the erector spinae block (ESB) and quadratus lumborum block (QLB) safely manage pain after surgery. Studies have found the ESB to be safe, with no reported side effects related to the block. It also reduces the need for opioids after hip surgery, allowing patients to experience less pain and require fewer painkillers.
The QLB effectively reduces pain after surgery as well. Research indicates it significantly decreases the need for opioids, similar to the ESB, thus managing pain well without major side effects.
Both blocks use ropivacaine, a commonly used and generally well-tolerated medication for pain relief. Overall, both blocks appear to be safe options for reducing pain after hip surgery and help lower the need for opioids, which can have their own side effects.12345Why are researchers enthusiastic about this study treatment?
Researchers are excited about the use of erector spinae and quadratus lumborum blocks for postoperative hip surgery pain because these techniques offer targeted pain relief with potentially fewer side effects compared to systemic pain medications like opioids. Unlike standard oral or intravenous pain medications, these blocks deliver ropivacaine directly to specific areas near the spine, which can help numb the pain at its source. This localized approach might lead to better pain management and quicker recovery times, reducing the need for more generalized pain relief methods that can affect the entire body. The use of ropivacaine, known for its long-lasting effects and lower risk of toxicity, further enhances the potential benefits of these nerve blocks.
What evidence suggests that this trial's treatments could be effective for postoperative hip surgery pain?
This trial will compare the effectiveness of the erector spinae block (ESB) and the quadratus lumborum block (QLB) for managing pain after hip surgery. Research has shown that both the ESB and QLB effectively manage postoperative pain. Specifically, studies have found that the ESB can greatly reduce pain and the need for opioid painkillers in the first 48 hours after surgery. Patients who received the ESB reported less pain and used fewer opioids during recovery. Similarly, the QLB significantly lowered pain levels and opioid use within the first 24 hours after hip surgery. This evidence suggests that both blocks offer strong pain relief, helping patients recover more comfortably with fewer opioids.13678
Who Is on the Research Team?
ROLAND BRUSSEAU, MD
Principal Investigator
Boston Children's Hospital
Are You a Good Fit for This Trial?
This trial is for young individuals aged 15-30 with developmental acetabular dysplasia experiencing hip pain, who are undergoing unilateral hip surgery. They must be in good health (ASA I - III status) and not overweight (BMI ≤ 35). Those with blood clotting issues, severe neurodevelopmental delays, chronic pain syndromes, recent opioid use, or without parental/patient consent are excluded.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive either a single-shot erector spinae block or quadratus lumborum block in conjunction with continuous lumbar plexus block for postoperative analgesia
Follow-up
Participants are monitored for pain control and adverse events post-surgery
What Are the Treatments Tested in This Trial?
Interventions
- Erector Spinae Block
- Quadratus Lumborum Block
- Ropivacaine
Find a Clinic Near You
Who Is Running the Clinical Trial?
Boston Children's Hospital
Lead Sponsor