PENG vs. QLB vs. Lumbar ESPB in Total Hip Surgery

Kafrelsheikh University

Status: Enrolling

Conditions: ESPB; Total Hip Surgery; Pericapsular Nerve; Quadratus Lumborum

Treatments: Procedure: Lumbar ESPB Technique; Procedure: Transmuscular QLB-t block Technique; Procedure: PENG block Technique

Study type: Interventional

Funder types: Other

Identifiers

NCT05600244

MKSU 50-9-21

Details and patient eligibility

About

The aim of this study is to compare between Pericapsular Nerve Group Block, Erector Spinae Plane Block and Quadratus Lumborum Block for managing acute postoperative pain in patients undergoing total hip surgeries under spinal anesthesia.

Full description

Total hip surgeries are one of the most common major orthopedic procedures to improve patient's functional status and quality of life. However, despite these advantages, the immediate postoperative period can be associated with severe pain that delays mobilization and increases hospital stay and the risk of thromboembolic events.

Various methods are used for postoperative pain management. Intravenous opioid agents are among them, but they may cause undesirable side effects, such as respiratory depression, sedation, constipation, allergic reaction, nausea, and vomiting. Thus, alternative techniques are preferred.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18-65 years
• Both genders
• Body mass index < 40 kg/m^2
• American Society of Anesthesiologists (ASA) physical status I-III
• Posted for total hip surgeries under spinal anesthesia

Exclusion criteria

• The presence of contraindications or allergy to local anesthetic agents
• Chronic use of opioids or corticosteroids
• Infection at the puncture site
• Coagulopathy
• Psychiatric disorders (dementia or cognitive impairment.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 3 patient groups

PENG block Technique

Experimental group

Description:

Patients will receive ultrasound-guided Pericapsular Nerve Group Block using 30 ml bupivacaine 0.25%.

Treatment:

Procedure: PENG block Technique

Lumbar ESPB Technique

Experimental group

Description:

Patients will receive lumbar erector spinae plane block using 30 ml bupivacaine 0.25%

Treatment:

Procedure: Lumbar ESPB Technique

Transmuscular QLB-t block Technique

Experimental group

Description:

Patients will receive transmuscular quadratus lumborum block using 30 ml bupivacaine 0.25%

Treatment:

Procedure: Transmuscular QLB-t block Technique