Quality of Recovery After Hip Fracture Surgery: US-guided PENG Block Versus FICB

University Tunis El Manar

Status: Completed

Conditions: Enhanced Recovery After Surgery

Treatments: Procedure: PENG vs FICB

Study type: Interventional

Funder types: Other

Identifiers

NCT05968014

Chaima Debabi

Details and patient eligibility

About

Patients were randomly divided into two groups to receive either ultrasound-guided pericapsular nerve group block (PENG group) or fascia iliaca compartment block (FICB group), using 20 ml of 0.2% ropivacaine

Full description

Participants were randomly divided into two groups : group PENG and group FICB, to receive either ultrasound-guided pericapsular nerve group block or fascia iliaca compartment block, using 50 ml of 0.2% ropivacaine.

For the FICB, a linear ultrasound probe was placed in the transverse plane and start scanning at the level of the inguinal crease to identify the femoral artery medially and the femoral nerve lateral to the femoral artery. The iliopsoas muscle should be seen overlying fascia iliaca. The block should be performed proximal to the arterial bifurcation. A 50 mm needle was introduced using an in-plane approach to penetrate the fascia iliaca. The hydro dissection separate the fascia iliaca from the iliac muscle, and a total volume of 20 ml of 0.2% ropivacaine was injected in this created space.

The PENG bloc is performed with a low frequency curvilinear ultrasound probe, which was initially placed in a transverse plane over the antero inferior iliac spine and the aligned with the pubic ramus by rotating the probe counterclockwise approximately 45 degrees. In this view, it is possible to observe the iliopubic eminence, the iliopsoas muscle tendon, the femoral artery and the pectineus muscle. A 100 mm needle was inserted from lateral to medial in an in-plane approach to place the tip in the musculofascial plane between the psoas tendon anteriorly and the pubic ramus posteriorly. Negative aspiration should be observed before injection of local anaesthetic and a total volume of 20 ml of 0.2% ropivacaine was injected.

Spinal anesthesia was performed after 20 minutes.

QoR-15 score was assessed before the intervention and 24 hours postoperatively.

Enrollment: 80 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients aged above 65 years
• patients with an american society of anesthesiologists physical status I to III
• patients undergoing hip fracture surgical repair

Exclusion criteria

• patients with an american society of anesthesiologists physical status IV or more
• inability or refusal to sign informed consent
• contraindications for regional nerve block or spinal anesthesia
• impaired cognition or dementia

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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80 participants in 2 patient groups

PENG block

Experimental group

Description:

Participants enrolled in this group received a pericapsular nerve group block with 20 ml of 0.2% ropivacaine. The block was performed with a 100 mm needle, inserted with an in-plane lateral to medial approach. Operator used a low frequency curvilinear probe.

Treatment:

Procedure: PENG vs FICB

FIC block

Experimental group

Description:

Patients allocated in this group received a fascia iliaca compartment block with 20 mL of 0.2% ropivacaine, using a 50 mm needle inserted with an in-plane approach. Operator used a linear probe.

Treatment:

Procedure: PENG vs FICB