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COMPLETED
NCT07427082
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Comparison of Lumbar Erector Spinae Plane Block and Spinal Anesthesia in Hip and Proximal Femur Surgery

Sponsor: Gaziantep City Hospital

View on ClinicalTrials.gov

Summary

Hip and proximal femur surgeries are commonly performed in elderly patients and require anesthetic techniques that provide adequate surgical anesthesia while minimizing the need for additional opioid administration. Spinal anesthesia is widely used for these procedures; however, it may be associated with intraoperative opioid requirements and hemodynamic changes. The lumbar erector spinae plane (ESP) block is a regional anesthesia technique that may be used as an alternative anesthetic approach in hip and proximal femur surgery. This prospective, randomized, single-blind study compares ultrasound-guided lumbar erector spinae plane block performed at the L4 level with spinal anesthesia in patients undergoing hip and proximal femur surgery. A total of 68 adult patients with ASA physical status I-III were allocated to receive either lumbar ESP block or spinal anesthesia. All patients received standardized premedication consisting of intravenous midazolam 2 mg and fentanyl 100 µg. The study evaluated the applied anesthetic technique, intraoperative opioid use and the time to first postoperative rescue analgesic administration. Patients in whom adequate anesthesia could not be achieved with the assigned technique and required conversion to general anesthesia were excluded from the final analysis. The results of this study may help determine whether lumbar ESP block is a feasible and safe alternative to spinal anesthesia in hip and proximal femur surgeries.

Official title: Comparison of Efficacy and Safety Between Ultrasound-Guided L4 Level Lumbar Erector Spinae Plane Block and Spinal Anesthesia in Hip and Proximal Femur Surgery

Key Details

Gender

All

Age Range

18 Years - 80 Years

Study Type

INTERVENTIONAL

Enrollment

66

Start Date

2022-07-01

Completion Date

2022-09-01

Last Updated

2026-04-15

Healthy Volunteers

No

Interventions

PROCEDURE

Ultrasound-Guided Lumbar Erector Spinae Plane Block (L4)

Ultrasound-guided lumbar erector spinae plane (ESP) block performed at the L4 level using a total of 30 mL local anesthetic solution (15 mL 0.5% isobaric bupivacaine + 7.5 mL 2% lidocaine + 7.5 mL 0.9% NaCl). All participants receive standardized premedication with midazolam 2 mg IV and fentanyl 100 µg IV prior to the procedure. Intraoperative opioid requirement/consumption and time to first postoperative rescue analgesic administration are recorded. Participants requiring conversion to general anesthesia due to inadequate anesthesia are considered block failures and are excluded from final analysis.

PROCEDURE

Spinal Anesthesia (L4-L5)

Spinal anesthesia performed at the L4-L5 interspace according to institutional routine practice. All participants receive standardized premedication with midazolam 2 mg IV and fentanyl 100 µg IV prior to the procedure. Intraoperative opioid requirement/consumption and time to first postoperative rescue analgesic administration are recorded.

Locations (1)

Gaziantep University

Gaziantep, Turkey (Türkiye)