PENG and LFCN Block Versus FIC Block for Multimodal Analgesia After Total Hip Replacement Surgery: a Retrospective Analysis Focused on Movement (Retro-PvF)

NCT06342102 | Completed

• 1 other identifier: ID 4286
• Study Type: observational
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

Total hip arthroplasty is a major surgical procedure performed on a growing number of patients. Optimal pain control with limited muscle weakness is paramount for a swift initiation of physical therapy and ambulation, thus expediting hospital discharge. Amongst the many peripheral nerve blocks, FIB (fascia iliaca block) has been recommended as the block of choice by many international guidelines since it offers the best pain control with a relatively low risk of motor block. PENG (pericapsular nerve group) and its association with LFCN (lateral femoral cutaneous nerve) has been proposed as an effective alternative that offers comparable, If not better, pain control with a considerably lower risk for motor block compared to FIB. Given the novelty of this block, there are few published papers on the subject, mostly case series or case reports thus justifying the need for retrospective study.

Conditions

Regional Anesthesia Block; Regional Anesthesia; Total Hip Replacement Surgery; Total Hip Arthroplasty \(THA\)

Keywords

PENG; LFCN; fascia iliaca; THA; total hip replacement surgery; analgesia; movement; Peripheral nerve blocks

Outcome Measures

Primary Outcomes (1)

• Movement of the lower limb affected by surgery

  The Medical Research Council (MRC) Muscle Strength Scale (ranging scale from 0 to 5 0= no visible contraction, 5=normal power) was used to assess the degree of residual quadriceps femoris muscle paresis 6 hours postoperatively.

  6 hours after surgery

Secondary Outcomes (6)

• pain control

  6 hours after surgery

• pain control

  12 hours after surgery

• pain control

  24 hours after surgery

• Morphine Milligram Equivalents (MME) of "pro re nata" (PRN) opioid doses

  24 hours after surgery

• Morphine Milligram Equivalents (MME) of "pro re nata" (PRN) opioid doses

  6 hours after surgery

Other Outcomes (2)

• time to first opioid request

  From date of surgery until up to 3 days after

• time to first postoperative ambulation

  From date of surgery until up to 3 days after

Study Arms (2)

PENG + LFCN Block

group in which PENG + LFCN Block was performed

Procedure: PENG + LFCN block

FIC Block

group in which FIC Block was performed

Procedure: FIC block

Interventions

PENG + LFCN block PROCEDURE

The PENG block was performed under ultrasound guidance. After skin disinfection, the needle was advanced between the psoas tendon and pubic ramus where 20 mL of 0.5% ropivacaine were injected. The LFCN block was performed following the PENG block.10 ml of 0.5% ropivacaine were injected near the nerve into the fat-filled flat tunnel (FFFT) located at the level of the superior anterior iliac spine and lateral to the sartorius muscle.

Also known as: pericapsular nerve group block associated with lateral femoral cutaneous nerve block

PENG + LFCN Block

FIC block PROCEDURE

FICB was performed under ultrasound guidance. The needle was advanced above the fascia iliaca and 20 mL of 0.5% ropivacaine were injected

Also known as: fascia iliaca compartment block

FIC Block

Eligibility Criteria

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

Study Population

Historical cohort study conducted among all patients who had THA from November 2022 to October 2023 at the ASST Nord Milano - Bassini Hospital, Cinisello Balsamo, Milano, Italy.

You may qualify if:

• elective total hip replacement surgery for non-traumatic hip disease,
• age over 18 years,
• complete clinical chart including type of peripheral nerve block performed,
• signed consent form for spinal anesthesia and peripheral nerve block.

You may not qualify if:

• preoperative opioid therapy,
• having received a peripheral nerve block other than PENG + LFCN or FICB,
• having received general anesthesia,
• incomplete chart,
• documented muscle weakness
• deviation from the established post-operative analgesia protocol.

Sponsors & Collaborators

• Ospedale Edoardo Bassini: lead

Study Sites (1)

ASST Nord Milano - Ospedale E. Bassini

Cinisello Balsamo, Italy/Milano, 20092, Italy

Location

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical Doctor

Study Record Dates

• First Submitted: March 26, 2024
• First Posted: April 2, 2024
• Study Start: March 26, 2024
• Primary Completion: April 1, 2024
• Study Completion: April 30, 2024
• Last Updated: March 19, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)