A Comparative Study Between Ultrasound Guided Erector Spinae Plane Block and Combined Ultrasound Guided Pericapsular Nerve Group and Lateral Femoral Nerve Block Following Total Hip Arthroplasty

NCT06402006 | Completed

• 1 other identifier: FAMSU R79/2024
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The patients will be randomized into 2 equal groups by a computer-generated random numbers table, named group A, B. Group A: patients will receive Pericapsular nerve group block and lateral femoral cutaneous nerve blocks. Group B: Patients will receive Erector spinae plane block. After IV access insertion and oxygen nasal cannula application, monitoring will be applied for all patients, sedation in the form of midazolam 0.02mg/kg with or without fentanyl 0.5-1 mcg/kg will be administered to any of the patients who felt discomfort or could not tolerate the procedure. For (Group A) PENG block will be done before spinal anesthesia. LFCN block will be performed. For (Group B), ESP block will be done before spinal anesthesia. Spinal anesthesia will be chosen as the main anesthetic technique. In postoperative period all patients will receive the same adjuvant multimodal analgesia which will be 1000 mg of paracetamol with or without 30 mg ketorolac depending on comorbidities and depending on the patients" needs.

Conditions

Post Operative Pain

Outcome Measures

Primary Outcomes (3)

• individual visual analog pain scores at 0, 6, 12, 24 and 48 h postoperatively (VAS; 0 = no pain and 10 = worst pain imaginable).

  The primary outcomes include : individual visual analog pain scores at 0, 6, 12, 24 and 48 h postoperatively (VAS; 0 = no pain and 10 = worst pain imaginable).

  48 hours

• presence of moderate-to-severe pain, defined as pain score 4 or greater during the first 48 h postoperative.

  presence of moderate-to-severe pain, defined as pain score 4 or greater during the first 48 h postoperative.

  48 hours

• analgesic consumption in post-anesthesia care unit, and during the first 48 h post-surgery (converted to IV pethidine equivalents).

  analgesic consumption in post-anesthesia care unit, and during the first 48 h post-surgery (converted to IV pethidine equivalents).

  48 hours

Study Arms (2)

Combined hip joint PENG block and LFCN block

EXPERIMENTAL

Combined hip joint pericapsular nerve group block(PENG) and lateral femoral cutaneous nerve block

Procedure: PENG block; Procedure: LFCN block

ESP block

EXPERIMENTAL

Erector spinae plane block(ESP)

Procedure: ESP block

Interventions

PENG block PROCEDURE

pericapsular nerve group block

Combined hip joint PENG block and LFCN block

LFCN block PROCEDURE

Lateral femoral cutaneous nerve block

Combined hip joint PENG block and LFCN block

ESP block PROCEDURE

Erector spinae plane block

ESP block

Eligibility Criteria

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

You may qualify if:

• Patients American Society of anesthesiologists' physical status (ASA) I to III.
• Aged 18 to 65 years.
• Both sexes.
• Patients scheduled for total hip arthroplasty.

You may not qualify if:

• Patient refusal
• ASA physical status III or more.
• Patients with known allergy to any of the study drugs.
• Infection at the site of injection.
• Patients with history of cardiovascular disease.
• Patients with renal disease.
• Patients with hepatic disease.
• Patients with neuromuscular disease.
• Presence of any coagulopathy.
• Chronic opioid, gabapentin or pregabalin use.
• Patients with history of any psychiatric disorder.
• BMI more than 35 kg/m2.

Sponsors & Collaborators

• Ain Shams University: lead

Study Sites (1)

Ain shams university hospitals

Cairo, Egypt

Location

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Study Record Dates

• First Submitted: April 28, 2024
• First Posted: May 7, 2024
• Study Start: May 15, 2024
• Primary Completion: November 30, 2024
• Study Completion: November 30, 2024
• Last Updated: May 4, 2025

Record last verified: 2025-05

Locations

EG (1)