PENG Block Plus Local Infiltration Compared to PENG Block Alone in Hip Surgery

NCT05773365 | Active Not Recruiting

• 1 other identifier: 5177
• Study Type: interventional
• Target: 122
• Locations: 1 country
• Sites: 1

Brief Summary

Summary: Pain control after hip surgery is quite important for patients' recovery. Many regional techniques are available with the focus on motor sparing block to speed patient recovery. The investigators will compare pericapsular nerve group (PENG) block in addition to local skin infiltration to PENG block alone. The study population will be included for patient traumatic hip surgery. The study population will be divided into group. First group will receive PENG block and local anaesthetics infiltration and second group will receive PENG block. Our primary outcome is to compare numeric rating scale (NRS) between studied groups, and morphine requirements in the first 24 hours as a secondary outcome.

Conditions

Pain; Hip Fractures; Postoperative Pain; Postoperative Analgesia

Outcome Measures

Primary Outcomes (1)

• Pain scores

  The difference in patient numeric rating scale (NRS). 11 points scale, where 0 means no pain and 10 is worst possible pain. The higher pain scores means worse outcome between both groups.

  24 hours

Secondary Outcomes (1)

• Morphine requirement

  24 hours

Study Arms (2)

Pericapsular Nerve Group Block plus local infiltration

EXPERIMENTAL

Group A (study group) will receive both PENG block and local infiltration at the end of the surgery. Spinal anaesthesia will be administered to the patient using 7.5-12.5 mg heavy 0.5% bupivacaine at L3-L5 lumbar spine using 25 G spinal needle. If spinal anaesthesia is contraindicated or failed, patients will have general anaesthetics. General anaesthesia will be induced with 2-3 mcg/kg fentanyl, Propofol 1-2 mg/kg titrated to effect, and muscle relaxant if required. PENG block will be administered according to the description by injecting 20 ml of 0.25% bupivacaine below the psoas tendon. A 20 ml of 0.25% bupivacaine will be infiltrated by the surgeons to the tissues at the end of the surgery.

Other: PENG block with or without local anaesthetic infiltration

Pericapsular Nerve Group Block

ACTIVE COMPARATOR

In Group B, only PENG block will be administered in this arm

Other: PENG block with or without local anaesthetic infiltration

Interventions

PENG block with or without local anaesthetic infiltration OTHER

As mentioned.

Pericapsular Nerve Group Block; Pericapsular Nerve Group Block plus local infiltration

Eligibility Criteria

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

You may qualify if:

• American Society of Anaesthesiology (ASA) 1-3
• Traumatic hip surgeries (total hip arthroplasty, hemiarthroplasty, Dynamic hip screw).

You may not qualify if:

• Patient with cognitive impairment.
• Patient weight \< 50 kg.
• Allergy to medications used.
• Chronic kidney disease. (serum creatinine \> 2.5 mg/dl).

Sponsors & Collaborators

• Suez Canal University: lead

Study Sites (1)

Suez Canal University Hospital

Ismailia, Egypt

Location

Related Publications (5)

• Young AC, Buvanendran A. Pain management for total hip arthroplasty. J Surg Orthop Adv. 2014 Spring;23(1):13-21. doi: 10.3113/jsoa.2014.0013.

  PMID: 24641893 BACKGROUND

• Tran DQ, Salinas FV, Benzon HT, Neal JM. Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. 2019 Jan 11:rapm-2018-000019. doi: 10.1136/rapm-2018-000019. Online ahead of print.

  PMID: 30635506 BACKGROUND

• Giron-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular Nerve Group (PENG) Block for Hip Fracture. Reg Anesth Pain Med. 2018 Nov;43(8):859-863. doi: 10.1097/AAP.0000000000000847.

  PMID: 30063657 BACKGROUND

• Pascarella G, Costa F, Del Buono R, Pulitano R, Strumia A, Piliego C, De Quattro E, Cataldo R, Agro FE, Carassiti M; collaborators. Impact of the pericapsular nerve group (PENG) block on postoperative analgesia and functional recovery following total hip arthroplasty: a randomised, observer-masked, controlled trial. Anaesthesia. 2021 Nov;76(11):1492-1498. doi: 10.1111/anae.15536. Epub 2021 Jul 1.

  PMID: 34196965 BACKGROUND

• Lin DY, Brown B, Morrison C, Fraser NS, Chooi CSL, Cehic MG, McLeod DH, Henningsen MD, Sladojevic N, Kroon HM, Jaarsma RL. The Pericapsular Nerve Group (PENG) block combined with Local Infiltration Analgesia (LIA) compared to placebo and LIA in hip arthroplasty surgery: a multi-center double-blinded randomized-controlled trial. BMC Anesthesiol. 2022 Aug 6;22(1):252. doi: 10.1186/s12871-022-01787-2.

  PMID: 35933328 BACKGROUND

MeSH Terms

Conditions

Pain; Hip Fractures; Pain, Postoperative

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries; Postoperative Complications; Pathologic Processes

Study Officials

• Eslam Albayadi

  Suez Canal University, Ring Road, Ismailia, Egypt

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 6, 2023
• First Posted: March 17, 2023
• Study Start: July 18, 2023
• Primary Completion: May 1, 2025
• Study Completion: July 1, 2025
• Last Updated: December 18, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)