Application of Pericapsular Nerve Group (PENG) Block

Nanjing Medical University

Status: Active, not recruiting

Conditions: TURBT

Treatments: Procedure: obturator nerve block; Procedure: peng block

Study type: Interventional

Funder types: Other

Identifiers

NCT07078773

KY20240724-01

Details and patient eligibility

About

This study aims to determine the efficacy and safety of the Pericapsular Nerve Group (PENG) block in preventing obturator nerve reflex during transurethral resection of bladder tumors.

Full description

During transurethral resection of bladder tumors (TURBT), obturator nerve reflex is easily triggered during electrocautery. Currently, two primary methods are used to prevent obturator nerve reflex: deep neuromuscular blockade under general anesthesia and obturator nerve block. To date, no studies have confirmed the efficacy of the Pericapsular Nerve Group (PENG) block in preventing obturator nerve reflex.

This study recorded the percentage decrease in adductor muscle strength at various time points after the PENG block, the occurrence of intraoperative adductor muscle spasms, the duration of nerve block procedure, and the incidence of postoperative adverse events. The completion of this study could provide clinical evidence for selecting anesthesia methods in TURBT procedures and offer robust evidence-based support for relevant medical decisions by government health agencies.

Enrollment: 68 estimated patients

Sex: All

Ages: 18 to 79 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Aged 18 years or older;
• Scheduled for TURBT for unilateral bladder tumor;
• Able to understand and provide informed consent;

Exclusion criteria

• Patients who refuse or are unable to provide informed consent;
• Allergic to local anesthetics, insensitive to propofol or general anesthetics;
• Pregnant women;
• Severe liver dysfunction;
• Evidence of infection at or near the proposed puncture site;
• Any sensory or motor impairment of the lower limbs;
• Recent (within 6 months) lower limb joint replacement surgery.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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68 participants in 2 patient groups

PENG Group:Ultrasound-guided pericapsular nerve group (PENG) block.

Experimental group

Description:

A convex ultrasound probe (frequency 2-5 MHz) was positioned at the patient's inguinal ligament, with one end directed toward the anterior inferior iliac spine (AIIS), clearly visualizing the bony prominences of the iliopubic eminence and the AIIS. The needle tip was directed medially toward the pectineus muscle. Upon reaching the space between the pectineus muscle and the pubic bone, and after confirming the absence of blood on aspiration, 30 ml of 0.375% ropivacaine was injected.

Treatment:

Procedure: peng block

Control group : Ultrasound-guided obturator nerve block.

Active Comparator group

Description:

An ultrasound probe was positioned at the inguinal ligament, with the needle inserted parallel to the long axis of the probe. After confirming no blood upon aspiration, 15 ml of 0.375% ropivacaine was injected into the fascial plane between the adductor brevis and adductor magnus, as well as into the midportion of the adductor longus and adductor brevis muscles.

Treatment:

Procedure: obturator nerve block