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

NCT07683663 — Not applicable, Not yet recruiting, 84 participants, Dokuz Eylul University

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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

Registry	NCT07683663
Status	Not yet recruiting
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: triple, other
Enrollment	84 (Estimated)
Sponsor	Dokuz Eylul University (Other)
Conditions	Hip Osteoarthritis, Total Hip Arthroplasty (THA), Postoperative Pain, Acute Pain
Interventions	Supra-Inguinal Fascia Iliaca Compartment Block, Quadro-Iliac Plane Block (Procedure)
Dates	start 2026-06-30 (estimated), primary completion 2026-12-01 (estimated), completion 2027-06-01 (estimated), first posted 2026-07-06, last updated 2026-07-06
Locations	1 site in Turkey (Türkiye)

-Summary

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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+Arms and interventions

Arm	Type	Interventions	Description
SI-FICB	Active comparator	Procedure: Supra-Inguinal Fascia Iliaca Compartment Block	Patients receiving supra-inguinal fascia iliaca compartment block (single-shot, US-guided, 40 mL 0.25% bupivacaine, preoperative).
QIPB	Experimental	Procedure: Quadro-Iliac Plane Block	Patients receiving quadro-iliac plane block (single-shot, US-guided, 40 mL 0.25% bupivacaine, preoperative).

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.

+Outcome measures

Primary outcomes

Pain intensity at rest at 6 hours postoperatively [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

NRS pain at rest [0, 2, 4, 6, 12, 24, 48 hours postoperatively]
NRS pain on movement (active hip flexion) [0, 2, 4, 6, 12, 24, 48 hours postoperatively]
Cumulative opioid consumption [24 hours and 48 hours]

+Eligibility

Sex: All, ages: 18 Years to 75 Years

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)

+Locations (1)

Facility	City	Country	Status
Dokuz Eylül University	Izmir, Balçova	Turkey (Türkiye)

+Investigators

Onur Küçük, associate professor, Principal investigator, Dokuz Eylul University