PENG vs. QLB vs. Lumbar ESPB in Total Hip Surgery

NCT05600244 | Unknown

• 1 other identifier: MKSU 50-9-21
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to compare between Pericapsular Nerve Group Block, Erector Spinae Plane Block and Quadratus Lumborum Block for managing acute postoperative pain in patients undergoing total hip surgeries under spinal anesthesia.

Conditions

Total Hip Surgery; Pericapsular Nerve; Quadratus Lumborum; ESPB

Outcome Measures

Primary Outcomes (1)

• Total amount of rescue analgesia

  Total amount of rescue analgesia in the form of morphine will be recorded

  24 hours postoperatively

Secondary Outcomes (3)

• First analgesic request

  24 hours Postoperatively

• Pain level

  48 hours Postoperatively

• Adverse events

  48 hours Postoperatively

Study Arms (3)

PENG block Technique

EXPERIMENTAL

Patients will receive ultrasound-guided Pericapsular Nerve Group Block using 30 ml bupivacaine 0.25%.

Procedure: PENG block Technique

Lumbar ESPB Technique

EXPERIMENTAL

Patients will receive lumbar erector spinae plane block using 30 ml bupivacaine 0.25%

Procedure: Lumbar ESPB Technique

Transmuscular QLB-t block Technique

EXPERIMENTAL

Patients will receive transmuscular quadratus lumborum block using 30 ml bupivacaine 0.25%

Procedure: Transmuscular QLB-t block Technique

Interventions

PENG block Technique PROCEDURE

A linear probe will be used. Puncture will be performed in a lateromedial direction until the needle tip reached the plane between the iliopsoas tendon and periosteum and between the anterior inferior iliac spine and iliopubic eminence. After a negative aspiration test, 30 ml of bupivacaine 0.25% will be injected in the plane beneath the iliopsoas muscle

PENG block Technique

Lumbar ESPB Technique PROCEDURE

Using the out-plane technique, a 22G/80-mm block needle will be advanced until it reached the transverse process. 0.5-1 ml of the prepared local anesthetic solution, 30 ml bupivacaine 0.25% will be administered leading to hydrodissection to confirm the correct location. The needle will be repositioned by pulling back a few millimeters if resistance occurs when administering local anesthetic . All local anesthetic will be administered to this location between the transverse process and the erector spinae muscle

Lumbar ESPB Technique

Transmuscular QLB-t block Technique PROCEDURE

A convex transducer will be placed in the transverse plane on the flank of the patient cranial to the iliac crest. The 4th lumbar vertebral transverse process, erector spinae muscles, psoas muscle, transverse abdominis muscle, internal and externa oblique muscles, and the quadratus lumborum muscle will be identified. A 15 cm 22G insulated needle will be inserted on the posterior corner of the transducer. 30 ml bupivacaine 0.25% will be administered between the quadratus lumborum and psoas muscles into the fascial plane.

Transmuscular QLB-t block Technique

Eligibility Criteria

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

You may qualify if:

• Age 18-65 years
• Both genders
• Body mass index \< 40 kg/m\^2
• American Society of Anesthesiologists (ASA) physical status I-III
• Posted for total hip surgeries under spinal anesthesia

You may not qualify if:

• The presence of contraindications or allergy to local anesthetic agents
• Chronic use of opioids or corticosteroids
• Infection at the puncture site
• Coagulopathy
• Psychiatric disorders (dementia or cognitive impairment.

Sponsors & Collaborators

• Kafrelsheikh University: lead

Study Sites (1)

Mohammad Fouad Algyar

Tanta, ElGharbiaa, 31511, Egypt

RECRUITING

Central Study Contacts

Mohammad F. Algyar, MD

CONTACT

111645345; mohammad.algaiar@med.kfs.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine

Study Record Dates

• First Submitted: October 26, 2022
• First Posted: October 31, 2022
• Study Start: December 15, 2022
• Primary Completion: October 10, 2023
• Study Completion: October 10, 2023
• Last Updated: September 6, 2023

Record last verified: 2023-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: One year after the end of the study

Locations

EG (1)