The PENG Block in Elective Hip Surgery and Its Effect on Postoperative Pain and Length of Stay.

Hôpital Fribourgeois

Status: Completed

Conditions: Pain, Postoperative

Treatments: Procedure: PENG block; Procedure: Placebo

Study type: Interventional

Funder types: Other

Identifiers

NCT05056675

2021-01792

Details and patient eligibility

About

Effective postoperative pain management in elective hip surgery is crucial for the patients well-being, rapid mobilisation and potential reduction of length of stay. In addition to standard intravenous pain medication, anaesthetic blocks are reportedly effective. Recently, the PENG block, a pericapsular pain block without impairment of the motor function has been introduced in literature and performed at the investigator's hospital (HFR Fribourg, Switzerland) for total hip arthroplasty and surgical hip dislocation - the two most commonly performed elective hip surgeries.

As high-quality evidence on the effectiveness of this novel block is lacking, the investigator's objective is to evaluate the effectiveness of (1) patient-reported pain reduction, (2) total consumption of postoperative morphine, and the length of stay at the hospital.

Full description

Forty patients undergoing total hip arthroplasty and 40 patients undergoing surgical hip dislocation will be enrolled in a prospective, double-blind, controlled trial performed at the investigator's hospital.

This study will be the first prospective study evaluating the potential of this pain block in elective hip surgery potentially affecting both patients' postoperative well-being and optimizing costs of the hospital by reducing length of stay.

Enrollment: 151 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Anterior total hip arthroplasty for hip osteoarthritis
• Surgical hip dislocation for femoro-acetabular impingement (type cam-/pincer)
• Age 16-85 years
• American Society of Anesthesiologists (ASA) physical status 1 to 3

Exclusion criteria

• Patient refusal/no informed consent
• Inability to give informed consent
• Lateral approach for total hip arthroplasty
• Bilateral procedure
• Additional osteotomies of the femur and/or acetabulum
• Previous hip & pelvis surgery
• Chronic opioid users
• Known allergy or intolerance to medications used in the trial (local anesthetic, opioid)
• Infection at the injection site
• Body mass index > 40kg/m2
• Spinal anesthesia

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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151 participants in 2 patient groups, including a placebo group

PENG block for anterior total hip arthroplasty or surgical hip dislocation

Experimental group

Description:

All patients will undergo the same preoperative, standardized protocol. Upon arrival to the operating theatre, routine, standard pre-medication will be applied before induction of general anesthesia. After intubation, the PENG block is performed. Under sonographic guidance, 20 mL of 0.5% ropivacaine iv is injected.

Treatment:

Procedure: PENG block

Placebo for anterior total hip arthroplasty or surgical hip dislocation

Placebo Comparator group

Description:

All patients will undergo the same preoperative, standardized protocol. Upon arrival to the operating theatre, routine, standard pre-medication will be applied before induction of general anesthesia. After intubation, the PENG block is performed. Under sonographic guidance, 20 mL of NaCL 0.9% is injected.

Treatment:

Procedure: Placebo