Comparison of Two Needle Placement Techniques for Lumbar Erector Spinae Plane Block During Hip Replacement Surgery

What this Trial Is About

Researchers are studying two different needle placement techniques for lumbar erector spinae plane block ESPB in patients undergoing hip replacement surgery. The study aims to compare how often sensory block occurs with the superficial technique versus the translaminar deep technique. This research also evaluates pain levels, motor block, recovery quality, and discharge readiness after surgery. Participants receive spinal anesthesia at L3-L4 using bupivacaine and are randomly assigned to receive either superficial ESPB, where the injection is on top of the L3 transverse process between bone and erector spinae muscle, or deep ESPB, where the injection is between L3 and L4 transverse processes in the fascial plane between the erector spinae and deep muscles. Additional medications include intravenous dexamethasone before surgery and scheduled ibuprofen and paracetamol around the clock postoperatively, with morphine delivered via patient-controlled analgesia as needed. During the study, participants are monitored for sensory block by testing skin sensitivity to cold within 24 hours. Secondary assessments include motor block, pain levels, morphine use, recovery quality, complications, and ability to be discharged, all measured up to 48 hours after surgery. The trial starts with screening and continues through the immediate postoperative period to assess these outcomes.

Comparison Between 2 Techniques for Lumbar-ESPB