Pericapsular Block Versus Trans Muscular Quadratus Lumborum Block in Patients Undergoing Correction of Hip Dysplasia

NCT06130761 | Completed DMC

• 1 other identifier: MD-302-2022
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of our study to compare the analgesic effect of pericapsular nerve group block combined with lateral femoral cutaneous nerve block and trans muscular quadratus Lumborum Block block perioperatively in pediatric patients undergoing developmental dysplasia of the hip surgical repair

Conditions

Hip Dysplasia

Keywords

quadratus lumborum blocks

Outcome Measures

Primary Outcomes (1)

• Time to first rescue analgesia .

  Time to first rescue analgesia 15 minutes after extubating the patient .

  15 minutes after extubation for 24 hours postoperative

Secondary Outcomes (4)

• Postoperative (FLACC)Face, Legs, Activity, Cry, Consolability scale.

  15 minutes after extubation for 24 hours postoperative

• Total intraoperative analgesic (fentanyl) requirements

  Intraoperative

• Total postoperative analgesic requirements

  15 minutes after extubation for 24 hours postoperative

• Intraoperative hemodynamics every 10minutes heart rate, systolic, diastolic, mean arterial blood pressure

  Intraoperative

Study Arms (2)

PENG block (P group)

EXPERIMENTAL

PENG BLOCK : 0.5 ml/kg of 0.25% bupivacaine is deposited between the psoas tendon anteriorly and pubic ramus posteriorly lifting it , and to perform the LFCN block 0.1 ml/kg of 0.25% bupivacaine is injected in lateral to femoral artery below anterior superior iliac spine .

Procedure: Pericapsular Nerve Group Block Combined With Lateral Femoral Cutaneous Nerve Block

TQL block (Q group)

EXPERIMENTAL

QL is usually identified medial to the aponeurosis of transversus abdominis muscle vertically attached above the iliac crest. A 22-gauge 50 mm needle will be inserted in the plane from the posterior edge of the convex probe through the QL in an anteromedial direction. The needle tip will be placed between the PM muscle and the QL muscle and the local anesthetic will be injected into the fascial plane after aspiration test is negative. A volume 0.5 ml/kg of 0.25% bupivacaine is injected with maximum dose 2.5mg per kg of bupivacaine

Procedure: trans muscular quadratus lumborum block

Interventions

Pericapsular Nerve Group Block Combined With Lateral Femoral Cutaneous Nerve Block PROCEDURE

For PENG block transducer is placed in the transverse plane over the anterior inferior iliac spine (AIIS) and moved inferiorly to visualize the pubic ramus. The femoral artery and iliopubic eminence are visualized, and then, using an in-plane technique, a 22-gauge 50 mm needle is advanced from lateral to medial then 0.5 ml/kg of 0.25% bupivacaine is deposited between the psoas tendon anteriorly and pubic ramus posteriorly lifting it. For LFCN the transducer is placed immediately inferior to the anterior superior iliac spine (ASIS), parallel to the inguinal ligament. The tensor fasciae lata muscle (TFLM) and sartorius muscle (SaM) are then identified. The nerve appears as a small hypoechoic oval structure with a hyperechoic rim between the TFLM and SaM in a short-axis view or superficial to the SaM. A 22-gauge 50 mm needle is inserted in-plane in a lateral-to-medial orientation through the subcutaneous tissue. A fascial "pop" may be felt as the needle tip enters the plane.

Also known as: PENG block

PENG block (P group)

trans muscular quadratus lumborum block PROCEDURE

With the patient in the lateral position, after standard sterilization of skin and probe identify 3 layers of the abdomen. The transversus abdominis is traced more posteriorly until the transversus aponeurosis. usually we can find the peritoneum curves away from the muscles from anterior to posterior . Tilting the probe slightly caudal into the pelvis thus improves the view of the retroperitoneal fat and the tapered end of transversus aponeurosis. QL is usually identified medial to the aponeurosis of transversus abdominis muscle vertically attached above the iliac crest. A 22-gauge 50 mm needle will be inserted in the plane from the posterior edge of the convex probe through the QL in an anteromedial direction. The needle tip will be placed between the PM muscle and the QL muscle and the local anesthetic will be injected into the fascial plane after aspiration test is negative. A volume 0.5 ml/kg of 0.25% bupivacaine is injected with maximum dose 2.5mg per kg of bupivacaine.

Also known as: TQL block

TQL block (Q group)

Eligibility Criteria

• Age: 6 Months - 6 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Acceptance of the parents
• Children of both gender
• ASA I \& ASA II
• Age ranging between 6 months up to 6years old (neglected cases)
• Scheduled to DDH surgical repair (open reduction or osteotomy) either unilateral or bilateral.
• Revision cases.

You may not qualify if:

• Parent refusal
• ASA III, IV
• Infection at site of block
• History of allergy to local anesthetics
• Bleeding disorders with INR \> 1.5 and/or platelets \< 100,000/mm3

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Anesthesia Department, Kasralainy Faculty of Medicine, Cairo University.

Cairo, 1772, Egypt

Location

MeSH Terms

Conditions

Hip Dislocation

Condition Hierarchy (Ancestors)

Joint Dislocations; Joint Diseases; Musculoskeletal Diseases; Wounds and Injuries; Hip Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Lecturer of Anesthesiology, Surgical ICU and Pain management

Study Record Dates

• First Submitted: April 9, 2023
• First Posted: November 14, 2023
• Study Start: April 4, 2023
• Primary Completion: March 11, 2024
• Study Completion: April 4, 2024
• Last Updated: May 31, 2025

Record last verified: 2023-11

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)