Postoperative Analgesia in Hip Arthroplasty

Balikesir University

Status: Active, not recruiting

Conditions: Hip Fractures; Postoperative Nausea and Vomiting; Post Operative Pain

Treatments: Procedure: suprainguinal fascia iliaca block; Procedure: Pericapsular nerve group (PENG) block

Study type: Interventional

Funder types: Other

Identifiers

NCT07153575

2023/142

Details and patient eligibility

About

The goal of this clinical trial is to compare analgesic effectiveness of two blocks in hip arthroplasty. The main question that aim to answer is;

-Which block is more efficient? Researchers will compare suprainguinal fascia iliaca block with perineural nerve group block.

Participants will randomized and one of the blocks will be applied.

Full description

Postoperative pain and analgesia in hip surgery is an important issue for early mobilization and length of hospital stay. The patient population is usually elderly. Prolonged hospital stay may cause thromboembolic complications due to delayed mobilization, psychiatric conditions such as delirium, and many undesirable conditions caused by pain such as chronicisation of acute pain. There are neuraxial analgesia, regional analgesia and multimodal analgesia regimens that are used together to prevent postoperative pain and to prevent these undesirable conditions caused by pain. Suprainguinal fascia iliaca block and pericapsular nerve group blocks are two of those. With performing these blocks, we will obtain postoperative analgesia and avoid postoperative complications.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Volunteer patients undergoing hip arthroplasty
• Voluntary patient to undergo elective operation under regional anaesthesia
• ASA I-II-III
• BMI≤35 kg/m²

Exclusion criteria

• Obstacles to the application of regional anaesthesia
• Local Anaesthetic Allergy
• Coagulopathy
• Psychiatric disorders and medication
• Hematological/Oncological disease
• Severe organ failure
• Multiple bone fractures
• Alcohol/Drug addiction
• Used analgesic medication up to 12 hours before surgery
• Infection at the Block Application Site
• Mental Deficiency
• Morbidly obese patients

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

Suprainguinal fascia iliaca block

Active Comparator group

Description:

The ultrasound-guided suprainguinal fascia iliaca block (SFIB) procedure was first described by Hebbard et al. in 2011. It is a prevalent regional anesthesia technique employed in surgical procedures involving the hip joint and femur. Local anesthetics are administered in close proximity to the fascia iliaca. The primary objective is to obstruct the femoral, obturator and lateral femoral cutaneous nerve in a simultaneous manner. In clinical practice, it is a safe and simple alternative to lumbar plexus blocks and femoral blocks. A 30-ml solution of 0.25% bupivacaine was injected between the iliac muscle and the iliac fascia. The bupivacaine dosage administered in the study was standardized for the groups by employing equal concentrations and volumes.

Treatment:

Procedure: suprainguinal fascia iliaca block

Pericapsular nerve group block

Active Comparator group

Description:

In pericapsular nerve group (PENG) block the local anesthetic agent is injected into the musculofascial plane between the psoas muscle tendon and the pubic ramus. The primary objective of this technique is to obstruct the genicular branches of the femoral, obturator, and accessory obturator which innervate the hip capsule. Therefore, a comparison with the SFIB was undertaken. A 30-ml block of 0.25% bupivacaine solution was injected between the pubic ramus and the iliopsoas muscle tendon. The bupivacaine dosage administered in the study was standardized for the groups by employing equal concentrations and volumes.

Treatment:

Procedure: Pericapsular nerve group (PENG) block