The Efficiency of Preoperative Pericapsular Nerve Group Block Applied With Ultrasound and Success of Spinal Anesthesia

NCT06209372 | Completed

• 1 other identifier: 281570
• Study Type: observational
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

We aimed to investigate the effectiveness of the pericapsular nerve group (PENG) block applied with preoperative ultrasonography (USG) in patients who were operated on under spinal anesthesia due to hip fracture and whether it influences spinal anesthesia success. The files of 100 patients were reviewed observationally, and 60 patients were included in the study. The patients were divided into two groups: Group P (n = 30) comprising patients who underwent PENG block under USG guidance before the start of surgery and the control group (Group C; n = 30) of patients in whom tramadol infusion was started. From the files of the patients, the transition from the bed to the operating table, lateral decubitus position, skin incision, postoperative exit, postoperative 2nd, 4th, 12th, and 24th hour numeric rating scale (NRS) values, spinal anesthesia duration and number of attempts, and perioperative total tramadol consumption were recorded. During the transfer from the patient bed to the operating table and during the lateral decubitus position, postoperative exit and postoperative 2nd, 4th, 8th, 12th, and 24th hour NRS values were found to be significantly lower in Group P. In addition, lower spinal anesthesia time, lower number of spinal anesthesia attempts, and lower perioperative total tramadol consumption were detected in Group P. We found that PENG block applied preoperatively to patients with spinal anesthesia decreased the perioperative pain score, increased the success of spinal anesthesia by facilitating positioning for spinal anesthesia, and decreased the need for postoperative opioids.

Conditions

Efficiency; Spinal Anesthesia; Block

Keywords

Fracture, Hip;; Block, Pericapsular Nerve Group;; Anesthesia, Spinal;; Success;; Ultrasound

Outcome Measures

Primary Outcomes (2)

• Change in pain score after applying Pericapsular Nerve Group Block (PENG)

  In line with the literature, we determined that the NRS value significantly decreased during positioning for spinal anesthesia in the group where the PENG block was applied.

  30 minutes after applying PENG block

• Pericapsular Nerve Group Block (PENG) block facilitates the success of spinal anesthesia

  Effective pain control facilitates the success of spinal anesthesia by making positioning and application easier is supported by our study.

  30 minutes after applying PENG block

Study Arms (2)

Group PENG (P)

Group PENG (P) received the PENG block with 20 mL of 0.25% bupivacaine under ultrasound guidance at preoperative care unit (PCU). The linear ultrasound probe for the PENG block was placed parallel to the imaginary line passing between the spina iliaca anterior inferior and the iliopubic eminence (IPE). The 80mm peripheral block needle was advanced with the in-plane technique, and the block was completed by injecting 20 mL of 0.25% bupivacaine.

Procedure: Group PENG

Group Control (C)

Group Control (C), patients who did not prefer the block were given 10 mg of IV bolus tramadol, followed by 10 mg/hr infusion at preoperative care unit (PCU).

Drug: Group C

Interventions

Group PENG PROCEDURE

Pericapsular Nerve Group Block (PENG)

Group PENG (P)

Group C DRUG

Tramadol infusion

Group Control (C)

Eligibility Criteria

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

Study Population

Patients undergoing hip fracture surgery

You may qualify if:

• Over 18 years old
• American Society of Anesthesiologists' (ASA) I-II-III

You may not qualify if:

• Patients with a history of chronic pain,
• Previous hip joint surgery,
• Unsuccessful PENG block or spinal anesthesia application,
• Missing data in their records
• History of bleeding diathesis
• Increased intracranial pressure
• Severe mitral and/or aortic stenosis
• Allergic to the medications used

Sponsors & Collaborators

• Suleyman Demirel University: lead

Study Sites (1)

Suleyman Demirel University Hospital

Isparta, Centre, 32200, Turkey (Türkiye)

Location

Related Publications (2)

• Acharya U, Lamsal R. Pericapsular Nerve Group Block: An Excellent Option for Analgesia for Positional Pain in Hip Fractures. Case Rep Anesthesiol. 2020 Mar 12;2020:1830136. doi: 10.1155/2020/1830136. eCollection 2020.

  PMID: 32231802 RESULT

• Afolayan JM, Areo PO, Adegun PT, Ogundipe KO, Filani AB. Comparison of ease of induction of spinal anaesthesia in sitting with legs parallel on the table versus traditional sitting position. Pan Afr Med J. 2017 Nov 13;28:223. doi: 10.11604/pamj.2017.28.223.6992. eCollection 2017.

  PMID: 29629009 RESULT

MeSH Terms

Conditions

Bites and Stings; Hip Fractures

Condition Hierarchy (Ancestors)

Poisoning; Chemically-Induced Disorders; Wounds and Injuries; Femoral Fractures; Fractures, Bone; Hip Injuries; Leg Injuries

Study Officials

• Eyyup Ozden

  Suleyman Demirel University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: October 5, 2023
• First Posted: January 17, 2024
• Study Start: December 15, 2021
• Primary Completion: April 15, 2022
• Study Completion: June 1, 2022
• Last Updated: April 26, 2024

Record last verified: 2024-04

Locations

TU (1)