Chronic pain and mobility outcomes following primary hip arthroplasty

• Research type

  Research Study

• Full title

  Chronic pain and mobility outcomes following primary hip arthroplasty. A comparison of intravenous morphine with lumbar plexus levobupivacaine.

• IRAS ID

  26236

• Contact name

  James Murray

• Sponsor organisation

  Belfast Health and Social Care Trust

• Eudract number

  2009-015840-40

• Research summary

  Total hip replacement is a successful procedure for the treatment of degenerative joint disease. Whilst much attention has been paid to limiting acute post-operative pain little has been done to impact upon the burden of chronic pain, which has recently been estimated to be as high as 28%. Traditionally pain control after surgery has been achieved using intravenous opiates such as morphine. Opiates are effective in controlling pain but have notable side effects such as nausea, vomiting and confusion, which may prevent early mobilisation following joint replacement surgery. Regional anaesthetic techniques, such as nerve blocks, can also provide good post-operative pain control. In addition nerve blocks may improve compliance with physiotherapy and reduce morphine usage, which may be beneficial in the short term. The objective of this study is to assess the longer term benefits of using a continuous lumbar plexus nerve block for pain relief following total hip replacement. A total of 240 patients will be recruited. These patients will be allocated to one of two groups. All patients will receive a standardised anaesthetic. One group will also receive a lumbar plexus nerve block to the operative side. A small catheter will be inserted to lie beside the lumbar plexus nerves. Post-operatively this will be attached to an infusion of local anaesthetic which will provide continuous pain relief for 48 hours. Both groups of patients will receive a patient controlled analgesia system containing morphine to keep them comfortable. Pain scores, incidence of nausea and mobility with a physiotherapist will be assessed in the first 48 hours post-operatively. All patients will be asked to fill out questionnaires about pain in their hip at 2, 6 and 12 months post surgery. This will investigate the incidence and severity of chronic pain following hip replacement and assess any difference between the analgesic techniques.

• REC name

  HSC REC B

• REC reference

  09/NIR02/59

• Date of REC Opinion

  19 Oct 2009

• REC opinion

  Favourable Opinion