Combined Ultrasound and Fluoroscopy-guided Technique for Anterior Hip Denervation

Mansoura University

Status: Unknown

Conditions: Hip Fractures

Treatments: Procedure: Modified technique for pericapsular nerve group block

Study type: Interventional

Funder types: Other

Identifiers

NCT04945668

MFM-IRB, R.21.05.1337

Details and patient eligibility

About

Hip fracture is a challenging geriatric problem for health care professionals, especially in patients with multiple comorbidities. In patients with inoperable hip fractures secondary to severe comorbid conditions, the pain can lead to significant challenges in nursing care.

A recent anatomical study confirmed the innervation of the anterior hip by these 3 main nerves but also found that the AON and FN play a greater role in the anterior hip innervation than previously reported.

Full description

The aim of this study is to help to target a suggested optimum landmark and determine the volume of injectate that can cover the distribution of the anterior articular branches supplying the hip joint.

The anterior hip capsule is innervated by the ON, accessory obturator nerve (AON), and FN as reported by previous anatomic studies. The anterior capsule is the most richly innervated section of the joint.

Ultrasound-guided technique for blockade of these articular branches to the hip, the PENG (Pericapsular Nerve Group) block reported significantly reduced pain scores compared with baseline.

With the current understanding of the complex innervations of the hip joint, it is difficult to provide complete effective radiofrequency ablation to the articular branches supplying the hip joint. Chemical hip denervation using ultrasound was reported by previous case reports or series without mentioning a well-defined target point or an optimum injectate volume.

Enrollment: 16 estimated patients

Sex: All

Ages: 50 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ASA physical status I, II, and III.
• Patients scheduled for elective or emergent hip fractures.

Exclusion criteria

• Patient refusal.
• Neuromuscular diseases (as myopathies, myasthenia gravies...)
• Hematological diseases, bleeding, or coagulation abnormality.
• Psychiatric diseases.
• Local skin infection and sepsis at the site of the block.
• Known intolerance to the study drugs.
• Body Mass Index > 40 Kg/m2.
• Multiple trauma patients.

Trial design

Primary purpose: Supportive Care

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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16 participants in 1 patient group

Pericapsular nerve group block

Other group

Description:

combined ultrasound and fluoroscopy-guided technique for pericapsular nerve group block

Treatment:

Procedure: Modified technique for pericapsular nerve group block