Pericapsular Nerve Group Block Versus Lumber Erector Spinae Plane Block for Pain Management After Total Hip Arthroplasty

NCT05050487 | Unknown

• 1 other identifier: T1991
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

Pain is a major problem that has to be dealt with in case of hip fracture, as it presents an obstacle for examination, positioning for receiving neuroaxial anesthesia and postoperative mobility and physiotherapy. With the introduction of ultrasound in regional anesthesia and peripheral nerve blocks, regional analgesia float to the surface as a substitute for opioids with less side effects Lumbar erector spinae plane block has emerged as a reliable analgesic option for primary total hip arthroplasty (THA). In 2018, a new block was described, termed pericapsular nerve group block or PENG block, that selectively targets the articular branches of the femoral and obturator nerves while sparing their motor components

Conditions

Post Operative Pain, Chronic

Outcome Measures

Primary Outcomes (1)

• Duration of analgesia

  the time passed from block to the patient's first analgesic request in hours

  24 hour

Study Arms (2)

treatment

EXPERIMENTAL

patient will recieve pericapsular nerve group block

Procedure: PENG block

treatement

EXPERIMENTAL

patient will receive lumbar erector spinae plane block

Procedure: lumbar erector spinae plane block

Interventions

PENG block PROCEDURE

The PENG block is performed under US guid¬ance, . The pa¬tient is placed in the supine position a curvilinear low-fre¬quency ultrasound probe (2-5 MHz) is initially placed in a transverse plane over the AIIS and then aligned with the pubic ramus by rotating the probe approximately 30-45 degrees . . The needle, usually a 22-G80-mm echogenic device, is inserted from lateral to medial with an in-plane approach to place the tip in the plane between the psoas tendon anteriorly and the pu¬bic ramus posteriorly . After needle insertion and following negative aspiration, the local anesthetic is injected . The volume used of 20 ml of(L-bupivacaine; concentration 0,25% ) . This fascial plane appeared to continue in the hip pericapsular plane.

Also known as: pericapsular nerve group block

treatment

lumbar erector spinae plane block PROCEDURE

The lumbar erector spinae block is performed under US guid¬ance, after adequate skin disinfection The patient is placed in the lateral decubitus position according to the selected site of surgical intervention. The 4th lumbar vertebral level will determined The convex USG transducer was placed at the mid-vertebral line in the sagittal plane. The transducer was shifted from the midline, 3.5-4 cm laterally to the side of the surgery to visualize the erector spinae muscle and transverse process . 0.5-1 ml of the prepared LA solution (20 ml bupivacaine 0.25%). All LA was administered to this location between the transverse process and the erector spinae muscle.

Also known as: ESPB

treatement

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• ASA grade 1\&2 \&3
• Adult patients (Age \>18 yrs)
• Eligible patients were aged 18 years or older, were admitted for hip arthroplasty (THA or HA) for femoral neck fracture, and had undergone a preoperative RA technique (PENG block or lumbar erector spinae plane block)

You may not qualify if:

• Patients with chronic pain before surgery (taking opioids)
• Patients with multiple trauma
• Patients who could not assess pain reliably (dementia)
• Patients who in anticoagulation
• Patient refused
• Infection at the side of injection

Sponsors & Collaborators

• Assiut University: lead

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Central Study Contacts

Abdeltwab Younis

CONTACT

01098518513; abdeltwabyonis91@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assisstant lecturer of anesthesia and intensive care

Model Details: randomized controlled trail

Study Record Dates

• First Submitted: September 10, 2021
• First Posted: September 20, 2021
• Study Start: June 30, 2022
• Primary Completion: October 30, 2023
• Study Completion: December 30, 2023
• Last Updated: April 28, 2022

Record last verified: 2022-04