Effect of Peng Block Application on Inflammation and Mortality in Hip Fractures

Ankara City Hospital

Status: Enrolling

Conditions: Hip Fractures; Inflammatory Response; Anesthesia

Treatments: Other: PENG block; Other: Control

Study type: Interventional

Funder types: Other

Identifiers

NCT06795724

E2-24-8891

Details and patient eligibility

About

In this study, the investigators the effect of PENG block on SIRI (systemic inflammation response index) and 30-day mortality in geriatric patients(over 65 years old) undergoing hip surgery, and the effect on the length of hospital stay.

Full description

Patients over the age of 65 who are scheduled for surgery due to hip fracture will be included in the study. According to the power analysis, a total of 60 patients will be included in the study. Patients will be divided into 2 groups by randomization.Multimodal analgesia will be applied to both groups. The first group will receive preoperative PENG block and the other group will not receive an analgesic block and will receive paracetamol and tramadol hydrochloride analgesia. All patients received spinal anesthesia using 10 mg bupivacaine. Preoperatively, IL-6, CRP, and hemogram tests will be performed on all patients and then these tests will be repeated 4, 24, and 48 hours after the surgical stimulus.

At the end of the operation, total bleeding amounts, blood products and amounts given, and operation time will be recorded. Postoperatively, NRS scores, initial analgesic requirements, hospital stays, and 30-day mortality will be monitored.

Enrollment: 60 estimated patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ASA 1-2-3 score
• Hip Fracture Surgery

Exclusion criteria

• Refusal to participate in the study
• ASA score of 4 and above
• Obesity (BMI >40)
• Failure of spinal block
• Switching to general anesthesia
• Patients undergoing revision surgery
• Patients with multitrauma
• Patients with old fractures (>3 weeks)
• Patients receiving preoperative and intraoperative sedation
• Patients with active malignancy receiving RT, KT
• Patients with active infection, patients receiving antibiotic treatment
• Patients with contraindications for regional anesthesia techniques
• Patients receiving chronic treatment with steroids or immunosuppressants
• Patients using anti-inflammatory drugs

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

PENG Block

Active Comparator group

Description:

PENG block will be performed before the surgery. For PENG block, patients are in the supine position is deposited. The convex ultrasound probe is initially placed over the anterior superior iliac spine, then the probe moves medially until the femoral artery is visualized. In this view, iliopectineal eminence (IPE), iliopsoas muscle and tendon, femoral artery and iliac muscle are observed. Between the psoas tendon and the IPE 22 gauge 80 mm block needle is guided and 20cc local anesthetic used in % 0.25 bupivacaine is administered by intermittent aspiration.

Treatment:

Other: PENG block

Control

Other group

Description:

Standard analgesia method will be applied and analgesia will be provided with tramadol hydrochloride and paracetamol.

Treatment:

Other: Control