Evaluation of Anterior Quadratus Lumborum Block for Postoperative Analgesia in Hip Arthroscopy

• Sponsor: Hospital for Special Surgery, New York (Other)
• Overall Status: Completed
• CT.gov ID: NCT03432650
• Collaborator: (none)
• Enrollment: 96
• Location: 1
• Arms: 2
• Actual Duration (Months): 39.3
• Patients Per Site Per Month: 2.4

Study Details

Study Description

Brief Summary

Hip arthroscopy is performed frequently and the postoperative course often involves moderate to severe pain. There remains no definitive perioperative pain regimen that has been proven to be effective and safe for this ambulatory procedure. Some institutions perform peripheral nerve blocks either preoperatively or postoperatively as a rescue block. All of these PNBs lead to quadriceps weakness which may impede earlier mobilization and physical therapy. While some case reports exist, there have not been any studies evaluating the QLB for hip arthroscopy patients. As previously mentioned, the technique is easy to perform, well-tolerated by patients, and avoids side effects such as hypotension, urinary retention, or the quadriceps weakness associated with lumbar plexus blockade.

Condition or Disease	Intervention/Treatment	Phase
Hip Disease	Drug: Bupivacaine + dexamethasone; Device: Ultrasound	Phase 3

Study Design

• Study Type: Interventional
• Actual Enrollment: 96 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Triple (Participant, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: Evaluation of Anterior Quadratus Lumborum Block for Postoperative Analgesia in Hip Arthroscopy: A Double-Blinded Randomized Controlled Trial
• Actual Study Start Date: Jun 1, 2018
• Actual Primary Completion Date: Dec 20, 2020
• Actual Study Completion Date: Sep 9, 2021

Arms and Interventions

Arm	Intervention/Treatment
Experimental: QLB Block + Standard of Care Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone).	Drug: Bupivacaine + dexamethasone; Anesthetic that will help treat pain and sensation after hip arthroscopy; Device: Ultrasound; Ultrasound will help guide the anesthesiologist in performing the nerve block
No Intervention: Standard of Care Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.

Outcome Measures

Primary Outcome Measures

1. Numerical Pain Rating System (NRS) Pain Scores [30min after Post Anesthesia Care Unite (PACU) arrival]

   Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

2. Numerical Pain Rating System (NRS) Pain Scores [1 hour after Post Anesthesia Care Unite (PACU) arrival]

   Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

3. Numerical Pain Rating System (NRS) Pain Scores [2 hours after Post Anesthesia Care Unite (PACU) arrival]

   Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

4. Numerical Pain Rating System (NRS) Pain Scores [3 hours after Post Anesthesia Care Unite (PACU) arrival]

   Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

5. Numerical Pain Rating System (NRS) Pain Scores [24 hours after Post Anesthesia Care Unite (PACU) arrival]

   Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.

Secondary Outcome Measures

1. Opioid Use [After Surgery to Post Operative Day 1]

   Amount of opioids taken after surgery

2. Number of Patients With Presence of IAFE (Intraabdominal Fluid Extravasation) Following Surgery [Immediately post-op in OR]

3. Number of Patients With Nausea/Vomiting [Up to Post Op Day 1]

4. Antiemetic Use [Up to Post Op Day 1]

5. Number of Participants With Hospital Admission [Up to Post Op Day 1]

6. Patient Satisfaction With Post Op Pain Control [Up to Post Op Day 1]

   Scale of 0-10; 0 being extremely dissatisfied and 10 being extremely satisfied

7. Patient Score on Quality of Recovery-40 (QoR40) Inventory. [Up to Post Op Day 1]

   Validated QoR40 survey score. Survey questions are added up to provide a final score. Higher score is reflective of a better outcome. Minimum score is 40, maximum score is 200.

8. Change in Quadriceps Motor Strength on Surgical Side [Up to Post Op Day 1]

   Change in Quadriceps Motor Strength from Pre-Op Baseline Quadriceps Strength

9. Urinary Retention [Up to Post Op Day 1]

   Incidence of Urinary Retention in recovery

10. Incidence of Hypotension [Up to Post Op Day 1]

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 80 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Patients scheduled for hip arthroscopy

• Ability to follow study protocol

• English Speaking

Exclusion Criteria:

• Hepatic or renal insufficiency

• Younger than 18 years old and older than 80

• Allergy or intolerance to one of the study medications

• Chronic gabapentin/pregabalin use (regular use for longer than 3 months)

• Chronic opioid use (daily opioids use for longer than 3 months)

• Patients contraindicated to undergo a spinal anesthetic

• Non English Speakers

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Hospital of Special Surgery	New York	New York	United States	10021

Sponsors and Collaborators

• Hospital for Special Surgery, New York

Investigators

• Principal Investigator: Stephen Haskins, MD, Hospital for Special Surgery, New York

Study Documents (Full-Text)

• Study Protocol and Statistical Analysis Plan - Apr 23, 2019

More Information

Publications

None provided.

• Responsible Party: Hospital for Special Surgery, New York
• ClinicalTrials.gov Identifier: NCT03432650
• Other Study ID Numbers: 2018-0647
• First Posted: Feb 14, 2018
• Last Update Posted: Aug 19, 2022
• Last Verified: Jul 1, 2022

• Individual Participant Data (IPD) Sharing Statement: No
• Plan to Share IPD: No
• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No
• Additional relevant MeSH terms: Dexamethasone; Bupivacaine

Study Results

Participant Flow

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Period Title: Overall Study
STARTED	48	48
COMPLETED	48	48
NOT COMPLETED	0	0

Baseline Characteristics

Arm/Group Title	QLB Block + Standard of Care	Standard of Care	Total
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.	Total of all reporting groups
Overall Participants	48	48	96
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	36 (13)	36 (12)	36 (13)
Sex: Female, Male (Count of Participants)
Female	26 54.2%	24 50%	50 52.1%
Male	22 45.8%	24 50%	46 47.9%
Race and Ethnicity Not Collected (Count of Participants)
Count of Participants [Participants]	0 0%
BMI (Body Mass Index) (kg/m^2) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [kg/m^2]	26 (5.7)	24.9 (3.8)	25 (4.9)
Short Form-8 Health Questionnaire (units on a scale) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [units on a scale]	16 (4)	17 (6)	16.4 (5.2)

Outcome Measures

1. Primary Outcome

Title	Numerical Pain Rating System (NRS) Pain Scores
Description	Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.
Time Frame	30min after Post Anesthesia Care Unite (PACU) arrival

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
NRS at Rest	3.3 (3.4)	4.4 (3.3)
NRS with Movement	4.5 (4)	4.7 (3.6)

2. Primary Outcome

Title	Numerical Pain Rating System (NRS) Pain Scores
Description	Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.
Time Frame	1 hour after Post Anesthesia Care Unite (PACU) arrival

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
NRS at Rest	3.7 (3.2)	4.6 (3.7)
NRS with Movement	4.1 (3.2)	5.2 (2.9)

3. Primary Outcome

Title	Numerical Pain Rating System (NRS) Pain Scores
Description	Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.
Time Frame	2 hours after Post Anesthesia Care Unite (PACU) arrival

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
NRS at Rest	4.1 (2.1)	4.6 (2.4)
NRS with Movement	4.5 (2.3)	4.8 (2.5)

4. Primary Outcome

Title	Numerical Pain Rating System (NRS) Pain Scores
Description	Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.
Time Frame	3 hours after Post Anesthesia Care Unite (PACU) arrival

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
NRS at Rest	4.1 (2.3)	4.6 (2.2)
NRS with Movement	4.6 (2.3)	4.8 (2.4)

5. Primary Outcome

Title	Numerical Pain Rating System (NRS) Pain Scores
Description	Pain scores at rest and with movement will be through 24 hours after surgery. Score scale is from 0-10. 0 means no pain, 10 means worst pain. A lower score is a better outcome.
Time Frame	24 hours after Post Anesthesia Care Unite (PACU) arrival

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
NRS at Rest	3.3 (2.5)	3.8 (2.1)
NRS with Movement	5.7 (2.6)	5.7 (2.3)

6. Secondary Outcome

Title	Opioid Use
Description	Amount of opioids taken after surgery
Time Frame	After Surgery to Post Operative Day 1

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
Median (Inter-Quartile Range) [oral morphine equivalent units (mg)]	75	68

7. Secondary Outcome

Title	Number of Patients With Presence of IAFE (Intraabdominal Fluid Extravasation) Following Surgery
Time Frame	Immediately post-op in OR

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
Count of Participants [Participants]	9 18.8%	11 22.9%

8. Secondary Outcome

Title	Number of Patients With Nausea/Vomiting
Time Frame	Up to Post Op Day 1

Outcome Measure Data

Analysis Population Description

some patients did not answer survey questions

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
Nausea PACU	12 25%	7 14.6%
Nausea POD1 (24hr)	21 43.8%	19 39.6%
Vomiting PACU	0 0%	1 2.1%
Vomiting POD1 (24hr)	2 4.2%	3 6.3%

9. Secondary Outcome

Title	Antiemetic Use
Time Frame	Up to Post Op Day 1

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
Count of Participants [Participants]	18 37.5%	12 25%

10. Secondary Outcome

Title	Number of Participants With Hospital Admission
Time Frame	Up to Post Op Day 1

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
Count of Participants [Participants]	11 22.9%	9 18.8%

11. Secondary Outcome

Title	Patient Satisfaction With Post Op Pain Control
Description	Scale of 0-10; 0 being extremely dissatisfied and 10 being extremely satisfied
Time Frame	Up to Post Op Day 1

Outcome Measure Data

Analysis Population Description

some patients did not answer questionnaire.

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
PACU	8 (2)	9 (2)
POD1	8 (2)	9 (2)

12. Secondary Outcome

Title	Patient Score on Quality of Recovery-40 (QoR40) Inventory.
Description	Validated QoR40 survey score. Survey questions are added up to provide a final score. Higher score is reflective of a better outcome. Minimum score is 40, maximum score is 200.
Time Frame	Up to Post Op Day 1

Outcome Measure Data

Analysis Population Description

Some patients did not answer questionnaire

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	46	46
PACU	104.9 (7)	107.5 (7.1)
POD1	105.6 (7.4)	105 (7.3)

13. Secondary Outcome

Title	Change in Quadriceps Motor Strength on Surgical Side
Description	Change in Quadriceps Motor Strength from Pre-Op Baseline Quadriceps Strength
Time Frame	Up to Post Op Day 1

Outcome Measure Data

Analysis Population Description

some patients were lost to follow up

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	27	30
Mean (Standard Deviation) [kg]	-4.4 (3.3)	-3.5 (2.4)

14. Secondary Outcome

Title	Urinary Retention
Description	Incidence of Urinary Retention in recovery
Time Frame	Up to Post Op Day 1

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
Count of Participants [Participants]	1 2.1%	0 0%

15. Secondary Outcome

Title	Incidence of Hypotension
Time Frame	Up to Post Op Day 1

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	QLB Block + Standard of Care	Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
Measure Participants	48	48
Count of Participants [Participants]	16 33.3%	19 39.6%

Adverse Events

Time Frame	6 months following surgery
Arm/Group Title	QLB Block + Standard of Care		Standard of Care
Arm/Group Description	Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given. Patients will receive a single shot anterior QLB (30cc 0.5% Bupivacaine with 2mg preservative free dexamethasone). Bupivacaine + dexamethasone: Anesthetic that will help treat pain and sensation after hip arthroscopy Ultrasound: Ultrasound will help guide the anesthesiologist in performing the nerve block		Patients will receive either a spinal (4cc Mepivacaine) or combined spinal epidural anesthetic (dose up 50 5 cc 2% lidocaine) with IV sedation. Intraoperative anti-emetics will consist of IV ondansetron and IV dexamethasone. Intra-operative analgesics will be IV fentanyl, IV acetaminophen, IV ketorolac, and IV ketamine. No Block will be given.
All Cause Mortality
	QLB Block + Standard of Care		Standard of Care
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/48 (0%)		0/48 (0%)
Serious Adverse Events
	QLB Block + Standard of Care		Standard of Care
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/48 (0%)		0/48 (0%)
Other (Not Including Serious) Adverse Events
	QLB Block + Standard of Care		Standard of Care
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/48 (0%)		0/48 (0%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

All Principal Investigators ARE employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.