Comparison of Continuous Fascia Iliaca Compartment Block With Continuous PENG Block in Total Hip Replacement Cases

NCT06806865 | Completed DMC

• 1 other identifier: 2023.06.01.06
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Adequate pain management after total hip arthroplasty (THA) is crucial for early ambulation and patient satisfaction. However, due to the hip joint's innervation complexity, the optimal regional analgesia technique for THA remains controversial. Total hip arthroplasties are critical surgeries that can take steps to improve the quality of life and functional status of patients who do not respond to conservative treatments. However, patients may present with intense pain in the immediate postoperative period, resulting in inactivity, increased risk of complications, and greater opioid consumption, resulting in adverse effects and prolonged hospital stay. The challenging management of pain is explained by the complex innervation of the hip joint, in which the articular branches of the femoral, obturator, and accessory obturator nerves are responsible for the sensory innervation of the anterior capsule. This randomized clinical trial compares the analgesic efficacy of FICB and PENG block following THA. Our preliminary results will be postoperative pain scores. As our anesthesia clinic, we routinely perform these known methods after surgery in these cases. Traditional intravenous analgesia methods cause many undesirable side effects depending on the type of opioid used, and they are insufficient compared to regional anesthesia methods.

Conditions

Postoperative Pain; Regional Anesthesia; Pain Management; Total Hip Arthroplasty

Outcome Measures

Primary Outcomes (1)

• VAS scores

  The Visual Analogue Scale (VAS) measures pain intensity. It consists of a 10 cm line with two endpoints representing 0 ('no pain') and 10 ('pain as bad as it could be'). Ask the patient to rate their current level of pain by placing a mark on the line. VAS scores at rest and during movement will be recorded at 0 hours (PACU), and subsequently at 2, 6, 12, and 24 hours while the patient is in the orthopedic clinic.

  up to 24 hours after recovery unit

Secondary Outcomes (4)

• Total patient-controlled analgesia (PCA) consumption for 24 hours postoperatively

  Up to 24 hours

• intraoperative blood pressure

  from the beginning of anesthesia induction to the leaving the recovery unit

• need for additional analgesia or rescue analgesia

  up to 24 hours after surgery

• intraoperative heart rate

  from the beginning of anesthesia induction up to leaving the recovery unit

Study Arms (2)

PENG Group (periarticular nerve group)

ACTIVE COMPARATOR

Continuous PENG block is the group to be applied.

Procedure: Periarticular nerve group block (PENG)

SIFICB Group (supra-inguinal fascia iliaca compartment block)

ACTIVE COMPARATOR

Continuous supra-inguinal fascia iliaca compartment block is the group to be applied.

Procedure: Continuous supra-inguinal fascia iliaca compartment block (SIFICB)

Interventions

Periarticular nerve group block (PENG) PROCEDURE

The pericapsular nerve group (PENG) block targets the nerves that supply the hip capsule. The continuous PENG block will be applied immediately after general anesthesia is given to the participants under ultrasound guidance. 30 ml of 0.25% bupivacaine will be used.

PENG Group (periarticular nerve group)

Continuous supra-inguinal fascia iliaca compartment block (SIFICB) PROCEDURE

The supra-inguinal fascia iliaca compartment block (SIFICB) targets the femoral, lateral femoral cutaneous, and obturator nerves. Under ultrasound guidance, 30 mL of 0.25% bupivacaine is administered, followed by catheter placement for continuous infusion at 5 mL/h.

SIFICB Group (supra-inguinal fascia iliaca compartment block)

Eligibility Criteria

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

You may qualify if:

• Patients undergoing hip replacement for the first time
• Patients aged 18-65 years, ASAI-II (American Society of Anesthesiology classification)
• Patients without primary cancer and/or patients without metastatic bone fractures
• Patients without allergy to local anaesthetics
• Patients with an intellectual level that can use patient-controlled analgesia devices
• Patients with a standard bleeding profile
• Patients who gave written consent to participate in the study

You may not qualify if:

• patients who have had a hip replacement and/or revision
• patients who have primary cancer and/or fractures due to bone metastasis
• patients who have a local anaesthetic allergy and/or a history of it
• patients who are not intellectually competent enough to use a patient-controlled anesthesia device
• patients who have undergone reoperation due to any surgical complication (bleeding, etc.) within 24 hours after surgery
• patients who did not give written consent to participate in the study

Sponsors & Collaborators

• Namik Kemal University: lead

Study Sites (1)

Namık Kemal Üniversitesi

Tekirdağ, Süleymanpasa, 59030, Turkey (Türkiye)

Location

Related Publications (1)

• Baran O, Sahin A, Arar C. Comparative analysis of continuous pericapsular nerve group block and supra-inguinal fascia iliaca compartment block for postoperative analgesia in total hip arthroplasty: a randomized controlled trial. J Orthop Surg Res. 2025 Aug 6;20(1):729. doi: 10.1186/s13018-025-06055-w.

  PMID: 40770360 DERIVED

MeSH Terms

Conditions

Pain, Postoperative; Agnosia

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Masking Details: Participants will be randomly divided into two groups. The physician who will collect data in the orthopedic department will not know which group the participant is in.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: December 30, 2024
• First Posted: February 4, 2025
• Study Start: March 15, 2023
• Primary Completion: December 15, 2024
• Study Completion: December 15, 2024
• Last Updated: June 5, 2025

Record last verified: 2025-05

Locations

TU (1)