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NCT Number: NCT07410000

Ultrasound-Guided Quadro-Iliac Plane Block for Pain Management After Total Hip Arthroplasty

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.

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Key information

Conditions

Pain Management Agnosia Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pathological Conditions, Signs and Symptoms Perceptual Disorders Signs and Symptoms Total Hip Arthroplasty

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

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

Who can participate

Healthy volunteers accepted: No

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

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

Treatment and study plan

Quadro-Iliac Plane (QIP) Block

Procedure

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.

Other names: QIP Block

Sham Block

Procedure

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.

Other names: Control Block

Primary outcomes

  1. Postoperative 24-Hour Morphine PCA Consumption

    Time frame: Postoperative 24 hours

    Total amount of morphine delivered by the patient-controlled analgesia (PCA) device during the first 24 hours after surgery, recorded in milligrams (mg).

Secondary outcomes

  1. NRS Pain Scores at Rest and Movement

    Time frame: 2, 6, 12, 24, and 48 hours postoperatively

    Postoperative pain will be assessed using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst pain imaginable.

  2. QoR-15 Recovery Score

    Time frame: QoR-15 Recovery Score will be evaluated at the postoperative 48th hour

    The investigators will use the Turkish version of Quality of Recovery (QoR) / QoR-15 questionnaire.

    PART A How have you been feeling in the last 24 hours? (0 to 10, where: 0 = none of the time [poor] and 10 = all of the time [excellent])

    Able to breathe easily Been able to enjoy food Feeling rested Have had a good sleep Able to look after personal toilet and hygiene unaided Able to communicate Getting support from hospital doctors and nurses Able to return to work or usual home activities Feeling comfortable and in control Having a feeling of general well-being

    PART B Have you had any of the following in the last 24 hours? (10 to 0, where: 10 = none of the time [excellent] and 0 = all of the time [poor])

    Moderate pain Severe pain Nausea or vomiting Feeling worried or anxious Feeling sad or depressed

    [Total score range: 0-150 points]

  3. Lower Extremity Muscle Strength Score

    Time frame: Postoperative 6th and 12th hours

    Postoperative lower extremity muscle strength will be assessed at the 6th postoperative hour using a 0-5 grading scale, where 0 indicates no muscle contraction and 5 indicates normal strength.

    The scale is defined as follows:

    0 = no muscle contraction

    • = muscle contraction present without joint movement
    • = movement without overcoming gravity
    • = movement against gravity without resistance
    • = movement against partial resistance
    • = movement against full resistance (normal strength)

  4. Rescue Analgesic Requirement

    Time frame: Postoperative 0-48 hours

    Number of patients requiring rescue analgesia (IV meperidine 0.5 mg/kg) and total dose administered when NRS ≥ 4.

  5. Opioid-Related Side Effects

    Time frame: Postoperative 0-48 hours

    Opioid-related side effects will be assessed postoperatively

    Other opioid-related side effects, including pruritus, constipation, and somnolence, will be recorded as present or absent.

Study contacts

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

Mursel Ekinci, Assoc prof,MD

CONTACT

[email protected]

+905067137596

Mustafa Dikici, MD

CONTACT

[email protected]

+905055346540

Sponsors and collaborators

Lead sponsor

Bursa City Hospital

Other Gov

Registry information

Official study title

Effectiveness of Ultrasound-Guided Quadro-Iliac Plane Block for Pain Management After Total Hip Arthroplasty: A Prospective Randomized Study

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Feb 13, 2026
Registry last updated
Mar 27, 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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