PENG vs FICB for Hip Fracture in ED Patients

University of Virginia

Status: Enrolling

Conditions: Femoral Neck Fractures; Intertrochanteric Fractures

Treatments: Procedure: FICB; Procedure: PENG

Study type: Interventional

Funder types: Other

Identifiers

NCT05505604

HSR220275

Details and patient eligibility

About

Regional anesthesia for hip fractures has been shown to decrease rates of delirium in elderly patients with hip fractures as well as improve pain compared to systemic opioids. The Pericapsular Nerve Group (PENG) block has recently received attention as an alternative approach to femoral nerve block and Fascia Iliaca Compartment Block (FICB). The investigators seek to evaluate if there is a difference between the PENG and FICB in terms of efficacy of pain control in ED patients presenting with hip fracture. We hypothesize that the PENG block may be superior based on previous research.

Full description

Fractures of the proximal femur are a common presentation to the emergency department and are an acutely painful condition. This condition predominantly affects elderly patients who are at risk for delirium and more susceptible to the adverse effects of systemic opioids. Regional anesthesia is an recommended component of pain control for elderly patients with hip fracture. The investigators seek to compare the efficacy of pain control of the Pericapsular Nerve Group (PENG) block with the Fascia Iliaca Compartment Block (FICB).

Previous studies have suggested that the PENG block may be superior to the FICB for pain control and results in less thigh motor weakness. The investigators will compare pain control (by difference in mean VAS score at set time points), systemic opioid use (in mean morphine equivalents prior to surgery), and motor function in patients with hip fractures who receive either block in the ED.

Enrollment: 50 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Proximal femur fracture

Exclusion criteria

• refusal to consent
• hemodynamic instability
• allergy to local anesthetics
• severe injury with instability
• severe medical conditions with instability

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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50 participants in 2 patient groups

PENG

Active Comparator group

Description:

Patients with hip fracture randomized to receive PENG block

Treatment:

Procedure: PENG

FICB

Active Comparator group

Description:

Patients with hip fracture randomized to received FICB

Treatment:

Procedure: FICB