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NCT Number: NCT07683663

QIPB vs SI-FICB for Postoperative Analgesia After Total Hip Arthroplasty

Total hip arthroplasty (THA) causes moderate-to-severe postoperative pain. The PROSPECT guideline recommends the supra-inguinal fascia iliaca compartment block (SI-FICB) for THA, whereas evidence for newer quadratus-lumborum-family blocks is limited. The quadro-iliac plane block (QIPB) is a recently described fascial plane block, and no study has compared QIPB with SI-FICB head-to-head in any surgical context. In this prospective, double-blind, patients undergoing elective THA who receive one of the two routinely used preoperative blocks (SI-FICB or QIPB, chosen by the attending anesthesiologist as part of routine care) are systematically observed and compared. The primary objective is to assess whether the postoperative analgesic efficacy of QIPB is non-inferior to SI-FICB, using the resting NRS pain score at 6 hours postoperatively as the primary endpoint (non-inferiority margin Δ = 1.3).

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Key information

Conditions

Hip Osteoarthritis Acute Pain Arthritis Joint Diseases Musculoskeletal Diseases Neurologic Manifestations Osteoarthritis Osteoarthritis, Hip Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Postoperative Pain Rheumatic Diseases Signs and Symptoms Total Hip Arthroplasty (THA)

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Dokuz Eylül University

Izmir, Balçova, 35340, Turkey (Türkiye)

Location contact

Onur Küçük, associate professor

CONTACT

[email protected]

5358543333 ext. +90

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults aged 18-75 years
  • Scheduled for elective primary total hip arthroplasty
  • ASA physical status I-III
  • Able to understand and communicate in Turkish and complete assessment scales
  • Completed preoperative anesthesia evaluation and approved for surgery
  • Signed written informed consent

Exclusion criteria

  • Known allergy/contraindication to any local anesthetic, including bupivacaine
  • Coagulopathy or anticoagulant/antiplatelet therapy contraindicating block (per ASRA 2022)
  • Active infection or skin breakdown at the block site
  • Chronic opioid use (≥3 months daily) or history of opioid dependence
  • Morbid obesity (BMI > 40 kg/m²)
  • Cognitive impairment or communication difficulty precluding reliable NRS/QoR-15 assessment
  • Pregnancy or breastfeeding
  • Revision THA or emergency THA for fracture
  • Intraoperative complications requiring major protocol deviation (e.g., >1000 mL blood loss, cardiac arrest)
  • Technically failed block (no sensory change at any region on the T1 cold test)

Treatment and study plan

Supra-inguinal fascia iliaca compartment block

Procedure

SIFICB is an ultrasound-guided fascial plane block performed via a supra-inguinal approach to the iliac fascia compartment, targeting the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve. Single-shot, US-guided, 40 mL 0.25% bupivacaine, before GA induction.

Quadro-Iliac Plane Block

Procedure

QIPB is a facial plane block performed under ultrasound guidance with local anesthetic in the interfascial plane between the erector spinae and the quadratus lumborum muscle, at the distal attachment site of the quadratus lumborum muscle on the iliac crest. Single-shot, US-guided, 40 mL 0.25% bupivacaine, before GA induction.

Primary outcomes

  1. Pain intensity at rest at 6 hours postoperatively

    Time frame: 6 hours after surgery

    Numeric Rating Scale (NRS), 0 = no pain to 10 = worst imaginable pain, measured at rest by a blinded assessor. Non-inferiority margin Δ = 1.3 NRS points.

Secondary outcomes

  1. NRS pain at rest

    Time frame: 0, 2, 4, 6, 12, 24, 48 hours postoperatively

  2. NRS pain on movement (active hip flexion)

    Time frame: 0, 2, 4, 6, 12, 24, 48 hours postoperatively

  3. Cumulative opioid consumption

    Time frame: 24 hours and 48 hours

Study contacts

Contact information is provided by the study sponsor or research team.

Onur Küçük, associate professor

CONTACT

[email protected]

5358543333 ext. +90

Sponsors and collaborators

Lead sponsor

Dokuz Eylul University

Other

Registry information

Official study title

Comparison of Quadro-Iliac Plane Block and Supra-Inguinal Fascia Iliaca Compartment Block for Postoperative Analgesia in Total Hip Arthroplasty: A Prospective, Double-Blind, Non-Inferiority Study

Important dates

Study start
2026
Primary completion
2026
Study completion
2027
First posted
Jul 6, 2026
Registry last updated
Jul 6, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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