Comparing Postoperative Pain After Pericapsular Nerve Block and Fascia Iliaca Block in Total Hip Arthroplasty

Ain Shams University

Status: Enrolling

Conditions: Anesthesia

Treatments: Procedure: pericapsular nerve block; Procedure: fascia iliaca compartment block; Procedure: palcebo fascia iliaca compartment block; Procedure: palcebo pericapsular nerve block

Study type: Interventional

Funder types: Other

Identifiers

NCT06003738

FMASU MD76/2023

Details and patient eligibility

About

The aim of this study is to investigate the efficiency of post-operative analgesia by fascia iliaca compartment block versus pericapsular nerve group block block in reducing narcotic consumption during the first 24 hour post-operatively by using the Visual Analogue Scale.

Full description

Total hip arthroplasty is a widely used surgical treatment intervention for treating hip conditions such as femur neck fractures and advanced hip osteoarthritis.

Hip fractures are quite common, regardless of the age of the population (young or old), and they are extremely painful. A hip fracture is a serious injury with potentially life-threatening complications, and it is a common orthopedic emergency in elderly individuals. Early surgery within 48 hours of a fracture has been found to lower mortality and complication rates.

The pericapsular nerve group block is a novel regional analgesia technique to decrease pain after THA while preserving the motor function. The local anaesthetic is deposited using this method in the fascial plane between the psoas muscle and the superior pubic ramus, which aims sensory branches of the obturator, accessory obturator, and femoral nerves in the anterior capsule of the hip.

Fascia iliaca compartment block, for procedures on the femur and hip joint, is still a well-liked regional anaesthetic technique. Studies have found that FICB prevents complications by anaesthetizing the femoral nerve far from critical neurovascular structures while still giving enough analgesia.

Both blocks could be used to effectively reduce pain intensity up to 24 hours, total opioid consumption, and length of hospital stay in THA patients.

Enrollment: 68 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age 18-80 years.
2. Sex: Both sexes.
3. American Society of Anaesthesiologists (ASA) Physical Status Class I, II, and III.
4. Scheduled for Total hip arthroplasty (THA) under spinal anesthesia.

Exclusion criteria

1. Declining to give a written informed consent.
2. History of allergy to the medications used in the study.
3. Contraindications to regional anesthesia (including patient refusal, coagulopathy, and local infection).
4. Psychiatric disorders.
5. Significant cognitive dysfunction.
6. American Society of Anesthesiologists (ASA) Physical Status Class IV.
7. Liver failure, renal insufficiency (estimated glomerular filtration rate < 15 mL/min/1.73 m2).
8. Patients who had failed spinal anaesthesia were excluded from the study.
9. Pregnancy.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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68 participants in 2 patient groups

The fascia iliaca compartment block group

Active Comparator group

Description:

The first group 34 patients

Treatment:

Procedure: palcebo pericapsular nerve block

Procedure: fascia iliaca compartment block

The pericapsular nerve block group

Active Comparator group

Description:

The second group 34 patients

Treatment:

Procedure: palcebo fascia iliaca compartment block

Procedure: pericapsular nerve block