Peri-capsular Nerve Group (PENG) Block and Quadratus Lumborum Block for Hip Arthroplasty

NCT05932498 | Completed DMC

• 1 other identifier: IRB108-235-A
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this randomized controlled clinical trial is to compare peri-capsular nerve group (PENG) block and quadratus lumborum (QL) block in participants who receive hip arthroplasty. The main question aims to answer is comparing the pain score among participants who receive PENG or QL block. Participants will be randomized and assigned into two groups. Participants will receive a PENG block in the PENG group and receive a QL block in the QL group. After participants receive hip arthroplasty, the investigators will compare the two groups to see if there is a difference of pain score, postoperative opioid consumption, sensation and motor function after nerve blocks, progress of functional recovery in lower limbs, intraoperative and postoperative complications.

Conditions

Post Operative Pain

Keywords

postoperative pain; nerve block; regional analgesia

Outcome Measures

Primary Outcomes (5)

• Comparing pain scores between the PENG and QL groups immediately after surgery

  Pain scores were assessed using a standard Visual Analog Scale (VAS), where a rating of 0 indicated the absence of pain, while a score of 10 denoted the presence of the most severe pain.

  10 minutes after surgery

• Comparing pain scores between the PENG and QL groups at the 1-hour postoperative mark

  Pain scores were assessed using a standard Visual Analog Scale (VAS), where a rating of 0 indicated the absence of pain, while a score of 10 denoted the presence of the most severe pain.

  at the 1-hour postoperative mark

• Comparing pain scores between the PENG and QL groups at the 12-hour postoperative mark

  Pain scores were assessed using a standard Visual Analog Scale (VAS), where a rating of 0 indicated the absence of pain, while a score of 10 denoted the presence of the most severe pain.

  at the 12-hour postoperative mark

• Comparing pain scores between the PENG and QL groups at the 24-hour postoperative mark

  Pain scores were assessed using a standard Visual Analog Scale (VAS), where a rating of 0 indicated the absence of pain, while a score of 10 denoted the presence of the most severe pain.

  at the 24-hour postoperative mark

• Comparing pain scores between the PENG and QL groups at the 48-hour postoperative mark

  Pain scores were assessed using a standard Visual Analog Scale (VAS), where a rating of 0 indicated the absence of pain, while a score of 10 denoted the presence of the most severe pain.

  at the 48-hour postoperative mark

Secondary Outcomes (6)

• Postoperative opioid consumption

  at the 12-, 24-, 48-hours after surgery

• The quadriceps strength on surgical side

  at the 0-, 1-, 12-, 24-, 48-, and 72-hours after surgery

• Time to independently sit at the edge of the bed after surgery

  From the date of hip surgery until the patient achieves independent sitting at the edge of the bed, with a maximum follow-up period of 7 days

• Time to stand up after surgery

  From the date of hip surgery until the patient achieves standing up, with a maximum follow-up period of 7 days

• Time to walk with the aid of walking devices after surgery

  From the date of hip surgery until the patient achieves walking with the aid of walking devices, with a maximum follow-up period of 7 days

Study Arms (2)

PENG group

EXPERIMENTAL

Participants with PENG block

Procedure: Hip surgery

QL group

ACTIVE COMPARATOR

Participants with QL block

Procedure: Hip surgery

Interventions

Hip surgery PROCEDURE

Ultrasound-guided PENG block was administered to patients undergoing hip surgery intraoperatively. OR Ultrasound-guided QL block was administered to patients undergoing hip surgery intraoperatively.

PENG group; QL group

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients who are 20 years of age or older (including 20 years of age).
• Non-emergency hip arthroplasty surgery.
• Able to understand and cooperate with preoperative and postoperative data collection.
• Grade one to three in the American Society of Anesthesiologists (ASA) physical status classification.

You may not qualify if:

• Under 20 years of age.
• A known allergy to the study medication (ropivacaine).
• Liver cirrhosis classified as Child Pugh Score C.
• Dementia or mental illness.
• Unable to assess their own pain level.
• Patients who have been using opioid drugs for a prolonged period.
• Having a history of drug or alcohol abuse within the last 6 months.
• Having serious illness and at a risk of imminent mortality.

Sponsors & Collaborators

• Buddhist Tzu Chi General Hospital: lead

Study Sites (1)

Po-Kai Wang

Hualien City, Hualien, 97002, Taiwan

Location

Related Publications (4)

• Min BW, Kim Y, Cho HM, Park KS, Yoon PW, Nho JH, Kim SM, Lee KJ, Moon KH. Perioperative Pain Management in Total Hip Arthroplasty: Korean Hip Society Guidelines. Hip Pelvis. 2016 Mar;28(1):15-23. doi: 10.5371/hp.2016.28.1.15. Epub 2016 Mar 31.

  PMID: 27536639 BACKGROUND

• Ueshima H, Otake H, Lin JA. Ultrasound-Guided Quadratus Lumborum Block: An Updated Review of Anatomy and Techniques. Biomed Res Int. 2017;2017:2752876. doi: 10.1155/2017/2752876. Epub 2017 Jan 3.

  PMID: 28154824 BACKGROUND

• La Colla L, Ben-David B, Merman R. Quadratus Lumborum Block as an Alternative to Lumbar Plexus Block for Hip Surgery: A Report of 2 Cases. A A Case Rep. 2017 Jan 1;8(1):4-6. doi: 10.1213/XAA.0000000000000406.

  PMID: 28036319 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

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

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

Study Officials

• Po-Kai Wang, MD, PhD

  Hualien Tzu Chi General Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Participants will not know which group they are in. Care provider, investigator, and outcomes assessor does not know which block participants will receive. The anesthesiologists who perform the blocks are not care provider, investigator, or outcomes assessor.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director, Division of Pain Management, Department of Anesthesiology

Model Details: one group is that participants receive PENG block and another group is that participants receive QL block for postoperative pain control.

Study Record Dates

• First Submitted: May 7, 2023
• First Posted: July 6, 2023
• Study Start: January 6, 2020
• Primary Completion: January 31, 2021
• Study Completion: January 31, 2021
• Last Updated: July 6, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)