Clinical Trial: Use of Regional Anesthesia in Hip Arthroscopy

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Use of Regional Anesthesia in Hip Arthroscopy

Brief Summary: The purpose of this research is to determine differences in outcomes in patients who do, or do not, receive regional anesthesia (a fascia iliaca block) prior to undergoing hip arthroscopy with labral repair and/or debridement and osteoplasty for hip impingement

Detailed Summary:

Patients undergoing hip arthroscopy for hip impingement at the investigator's institution often have regional anesthesia (a nerve block) prior to the procedure to help prevent and/or reduce pain following the procedure. The investigators are interested in determining benefits as well as potential adverse effects of utilizing regional anesthesia in patients undergoing hip arthroscopy for impingement. To do so, they plan to enroll patients aged 18-45 undergoing hip arthroscopy, and randomize them to one of two groups with one group receiving regional anesthesia pre-operatively and the second control group, that does not. The surgical procedure and the post-operative management will be the same for both groups.

Regional anesthesia prior to orthopaedic procedures has been widely adopted in many fields of orthopaedics. While it is generally considered safe and an excellent adjuvant for pain control, there have been few studies exploring outcomes beyond pain control. In many centers, the use of regional anesthesia in hip arthroscopy is reserved for post-operative management of pain. There are multiple studies indicating that patients receiving regional anesthesia (a fascia iliaca or femoral nerve block) had significantly greater improvements in pain score and even an excellent alternative to routine narcotic medication in patients undergoing hip arthroscopy. Other orthopaedic procedures, such as knee arthroscopy, utilize similar techniques to achieve post-operative pain control through a femoral-sciatic nerve block.

There have also been studies looking at the utilization of regional anesthesia via lumbar plexus blocks with hip arthroscopy. One study found that patients undergoing hip arthroscopy with higher levels of preoperative psychological distress frequently utilized a lumbar plexus block to achieve adequate pain control. O
Sponsor: Georgetown University

Current Primary Outcome: Pain Medication Requirement in PACU (In mcg fentanyl, tablets of acetaminophen, oxycodone, toradol) [ Time Frame: 24 hours post-operatively ]

Original Primary Outcome:

  • Pain Medication Requirement in PACU (In mcg fentanyl, tablets of acetaminophen, oxycodone, toradol) [ Time Frame: 24 hours post-operatively ]
  • Duration of PACU stay (mins) [ Time Frame: 24 hours post-operatively ]
  • Visual Analogue Pain Scores (VAS) [ Time Frame: 24 hours post-operatively ]
  • Long Term Pain Control (daily VAS record) [ Time Frame: 6 weeks ]
    Patients will complete a daily VAS questionnaire at home
  • Long Term Medication Requirements (daily log of medication usage in tablets of 5 mg oxycodone, morphine extended relief 15 mg, and/or indomethacin 75 mg) [ Time Frame: 6 weeks ]
  • Harris Hip Score [ Time Frame: 6 weeks ]
    Questionnaire administered at 6 week follow up to evaluate functional outcomes


Current Secondary Outcome:

  • Falls [ Time Frame: 6 weeks ]
  • Readmissions [ Time Frame: 6 weeks ]
  • Neuropathic Pain [ Time Frame: 2 weeks and 6 weeks ]
    Self Reported- Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaires will be completed at both 2 and 6 week follow-up
  • Time to Physical Therapy [ Time Frame: 6 weeks ]
  • Patient Satisfaction [ Time Frame: 6 weeks ]
    Survey administered at six week follow-up to determine satisfaction with surgery and anesthesia plan.
  • Duration of PACU stay (mins) [ Time Frame: 24 hours post-operatively ]
  • Visual Analogue Pain Scores (VAS) [ Time Frame: 24 hours post-operatively ]
  • Long Term Pain Control (daily VAS record) [ Time Frame: 6 weeks ]
    Patients will complete a daily VAS questionnaire at home
  • Long Term Medication Requirements (daily log of medication usage in tablets of 5 mg oxycodone, morphine extended relief 15 mg, and/or indomethacin 75 mg) [ Time Frame: 6 weeks ]
  • Harris Hip Score [ Time Frame: 6 weeks ]
    Questionnaire administered at 6 week follow up to evaluate functional outcomes


Original Secondary Outcome:

  • Falls [ Time Frame: 6 weeks ]
  • Readmissions [ Time Frame: 6 weeks ]
  • Neuropathic Pain [ Time Frame: 2 weeks and 6 weeks ]
    Self Reported- Leeds Assessment of Neuropathic Symtoms and Signs (S-LANSS) questionnaires will be completed at both 2 and 6 week follow-up
  • Time to Physical Therapy [ Time Frame: 6 weeks ]
  • Patient Satisfaction [ Time Frame: 6 weeks ]
    Survey administered at six week follow-up to determine satisfaction with surgery and anesthesia plan.


Information By: Georgetown University

Dates:
Date Received: July 26, 2016
Date Started: July 2016
Date Completion: August 2017
Last Updated: November 5, 2016
Last Verified: July 2016