Pericapsular Nerve Group Block in Hip Arthroplasty

Tanta University

Status: Completed

Conditions: Post Operative Pain After Hip Arthroplasty

Treatments: Procedure: pericapsular nerve group block

Study type: Interventional

Funder types: Other

Identifiers

NCT04336059

hip arthroplasty

Details and patient eligibility

About

Peripheral nerve blocks are becoming increasingly popular for hip surgery anesthesia. Modern regional anesthesia for major hip surgery includes the use of a single shot and continuous epidural or spinal injections, continuous lumbar plexus blockade and continuous peripheral blockade of the femoral nerve (FN), fascia iliaca (FI) block, 3-in-1 FN block and sciatic nerve. The use of either single shot or continuous peripheral nerve blocks are becoming increasingly popular.

This study will be conducted to evaluate the effect of ultrasound guided pericapsular nerve group block in hip arthroplasty surgery.

Full description

Hip joint is richly innervated, and the pain following hip arthroplasty is particularly severe. Effective postoperative analgesic technique especially in an elderly with significant comorbidities is challenging. (1) Peripheral nerve blocks are becoming increasingly popular for hip surgery anesthesia. Modern regional anesthesia for major hip surgery includes the use of a single shot and continuous epidural or spinal injections, continuous lumbar plexus blockade and continuous peripheral blockade of the femoral nerve (FN), fascia iliaca (FI) block, 3-in-1 FN block and sciatic nerve. The use of either single shot or continuous peripheral nerve blocks are becoming increasingly popular. (2) These techniques have shown effective and safe postoperative pain control, resulting in lower opioid consumption, improved earlier rehabilitation and high patient satisfaction. (3) Pericapsular nerve group (PENG) block has been recently recommended by Giron-Arango et al. for use as postoperative analgesia in hip surgeries. It is a new regional anesthesia method based on blocking the articular branches of femoral nerve (FN) and accessory obturator nerve(AON) and obturator nerve in the region between the anterior inferior iliac spine (AIIS) and ilio-pubic eminence (IPE).The anterior capsule is the most richly innervated section of the joint suggesting these nerves should be the main targets for hip analgesia. (4)

Enrollment: 50 patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients will involve in the research if they will schedule for unilateral hip arthroplasty (THA) surgery.
• aged more than 50 years of both genders.
• have American society of anesthiologists physical status I-II and III.

Exclusion criteria

• Revision hip arthroplasty.
• hip arthroplasty. combined with subtrochanteric shortening osteotomy.
• drug allergy.
• regular narcotic use.
• renal &/ or hepatic impairments.
• coagulopathy disorders.

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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50 participants in 2 patient groups

group 1

Other group

Description:

will receive sham PENG block with normal saline in total volume of 20 ml.

Treatment:

Procedure: pericapsular nerve group block

group 2

Experimental group

Description:

will receive real PENG block with bupivacaine (0.25%) in total volume of 20 ml.

Treatment:

Procedure: pericapsular nerve group block