Femoral Rami Obturator Nerve Trunk (FRONT) Block in Intramedullary Nail Surgery .

NCT07268911 | Recruiting

• 1 other identifier: ِAIP029-4
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The study propose that using femoral rami obturator nerve trunk(FRONT) block may help postoperative analgesia in nail femur surgeries. The technique is relatively new, introducing one needle to target two nerve blocks in the same entry point. The block spare motor fibers of femoral nerve so it may help both early mobilization and effective analgesia, which in turn enhance early recovery and better outcomes.

Conditions

Anterior Hip Analgesia

Outcome Measures

Primary Outcomes (1)

• Postoperative analgesia

  Pain level will be assessed after spinal anesthesia is resolved using rest/dynamic numeric rating scale (NRS) with patients rating their pain on a scale from 0 to 10. On this scale, 0 means "no pain" and 10 means "the worst pain imaginable"

  Patients will be followed for 36 hours postspinal and assessed for pain, at 2, 4, 6, 12, 18, 24, 36 hours

Secondary Outcomes (3)

• Opioid consumption

  When 36 hours postoperatively has passed.

• Motor function

  Patients will be followed for 36 hours postoperatively and assessed for motor function at 2, 4, 6, 12, 18, 24, 36 hours.

• Complication

  Patients will be followed for 36 hours postoperatively and assessed for presence of any complications or side effects at 2, 4, 6, 12, 18, 24, 36 hours

Study Arms (2)

FRONT Block

EXPERIMENTAL

Participants (n=42) will receive Ultrasound-guided FRONT block. n=42 patients. Powered at 90% to detect 1-point NRS superiority (SD 1.8, alpha 0.05).

Procedure: Femoral rami obturator nerve trunk (FRONT) block

Conventional Analgesia

ACTIVE COMPARATOR

Participants (n=42) patients will be assigned to intervention multimodal systemic analgesia. n=42 patients. Powered at 90% to detect 1-point NRS superiority (SD 1.8, alpha 0.05).

Drug: Multimodal systemic analgesia

Interventions

Femoral rami obturator nerve trunk (FRONT) block PROCEDURE

ultrasound-guided FRONT block will be performed at the infrainguinal level, targeting the iliopsoas plane. Using the same needle approach, the subpectineal compartment will be also accessed . We will use ultrasound and electrical nerve stimulation guidance (0.4 mA, 0.1 ms, without eliciting a motor response) to avoid direct involvement of the femoral nerve. A total of 40 mL (20 mL for the iliopsoas plane and 20 mL for the subpectineal compartment) of 0.125% plain levobupivacaine will be administered.

FRONT Block

Multimodal systemic analgesia DRUG

Standard postoperative protocol: * IV nalbuphine (6 mg bolus PRN when NRS\>4 ) * IV paracetamol 1g every 6 hours * IV ketorolac 30 mg every 8 hours PRN (NRS \>4)

Conventional Analgesia

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• the elderly age≥60 years
• American Society of Anesthesiologists (ASA) classification 1-2
• patients who undergoing surgery for intramedullary nail surgery.

You may not qualify if:

• patient refused to participate and consent
• patients with a history of mild cognitive impairment (MCI), dementia, and delirium
• patients with known preoperative infections (pulmonary infection, urinary infection, and sepsis).
• coagulopathy

Sponsors & Collaborators

• South Valley University: lead

Study Sites (1)

Qena University

Qina, Qena Governorate, 83511, Egypt

RECRUITING

MeSH Terms

Interventions

Dental Occlusion

Intervention Hierarchy (Ancestors)

Dentistry; Dental Physiological Phenomena; Digestive System and Oral Physiological Phenomena

Study Officials

• Zeinab M Sayed, MD

  Qena University

  STUDY DIRECTOR

Central Study Contacts

Zeinab M Sayed, MD

CONTACT

01009071365; zeinab5aton@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: lecturer in anesthesia, Intensive Care and Pain Management

Study Record Dates

• First Submitted: November 25, 2025
• First Posted: December 8, 2025
• Study Start: November 1, 2025
• Primary Completion: May 1, 2026
• Study Completion (Estimated): June 1, 2026
• Last Updated: February 19, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)