Two different block for pain relief after hip surgeries
- Conditions
- Periprosthetic fracture around internal prosthetic hip joint, (2) ICD-10 Condition: M970||Periprosthetic fracture around internal prosthetic hip joint,
- Registration Number
- CTRI/2022/07/043834
- Lead Sponsor
- Dr S N Medical Collage and attached hospital Jodhpur
- Brief Summary
The study will be conducted in Mahatama Gandhi hospital and Mathura Das Mathur Hospital of Dr S. N. Medical College and associated group of hospitals, Jodhpur after seeking clearance from the institutional ethical committee and obtaining written, informed consent from the patients. All patients will be examined during the preoperative visits, prior to surgery by an attending anesthesiologist. During the preoperative visit patient’s detailed history, general physical examination and systemic examination will be carried out. Basic demographic data like name, age, sex, height, and weight will be recorded. A detailed assessment of the airway will be performed to rule out any airway difficulty. Routine investigations will be carried out. Patients will be explained in detail about the procedure, drugs and the Numerical rating scale (NRS) ranging from 0 to 10 (0 = no pain and 10 = worst imaginable pain). The standard instruction of fasting will be given to all patients. After the arrival of the patient in the operation theatre, saturation monitors like continuous electrocardiogram (ECG), non-invasive blood pressure (NIBP) and peripheral oximetry will be applied on arrival to the operation theatre and baseline vitals will be recorded. A peripheral intravenous (IV) line will be secured with an 18 G cannula on the forearm and a 0.5ml/kg/hr crystalloid solution will be started. All the patients will receive spinal anaesthesia with 0.5% bupivacaine 15 mg (3 ml) heavy under all aseptic precautions. The block will be performed as per randomization, once the spinal anaesthesia effect is confirmed.
The block will be performed with an ultrasound machine. With the participants in a supine position, in group FIC block, the probe will place in a horizontal direction over the anterior part of the thigh just below the inguinal ligament. The ultrasound setting uses to visualise at a frequency of 10 MHz and a depth of 3-4 cm. The femoral artery will identify first. Group FIC, the iliacus muscle, covered by fascia iliaca will be identified lateral to the artery. A 20 G needle was then inserted in-plane into the ultrasound beam. The needle advance until the tip of the needle will place beneath the fascia iliaca and after negative aspiration, the local anaesthetic of 30 ml of 0.5% levobupivacaine will be injected and its spread visualized on the ultrasound screen.
Group PENG block, the anterior inferior iliac spine, the femoral artery (FA), the pectineus muscle, the iliopubic eminence, the iliopsoas muscle and tendon could be observed using a curvilinear low-frequency ultrasound probe. The puncture site will be set 0.5-1.0 cm away from the lateral of the ultrasound probe. A 22-gauge, 80-mm needle will be inserted carefully in an in-plane approach from lateral to inner. Following the tip of the needle reaches the musculofascial between the tendon of the psoas muscle anteriorly and the pubic ramus posteriorly, which is between the iliopubic eminence and anterior inferior iliac spine, 1 mL of 0.9% saline solution will be injected to ensure that the solution will be spread in the plane beneath the iliopsoas muscle. After negative aspiration, a total volume of 30mL of 0.5% levobupivacaine will be slowly injected after negative aspiration every 5 mL. The ultrasound view of the fluid spread in the plane will be observed to ensure that the LA is injected right into the targeted location.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 76
ASA physical status I and II undergoing hip surgeries (duration about 2.5 hours).
Patient refusal Uncooperative patient Hypersensitivity to local amide anaesthetics Infection at the injection site Pregnant woman Obesity Uncooperative patients Prior surgery at the corresponding area Bleeding disorders Peripheral neuropathy or neurological deficit Known hepatic or renal insufficiency Patient on concurrent chronic opioid or any other analgesic therapy,.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Duration of analgesia after ultrasound-guided Fascia iliaca compartment (FIC) block and Pericapsular Nerve Group (PENG) block on the postoperative analgesia in patients undergoing hip surgeries 24 HOURS
- Secondary Outcome Measures
Name Time Method 1. Analgesic consumption in post operative 24 hours 2. To assess quality of analgesia by using NRS score
Trial Locations
- Locations (1)
MDM hospital, Dr S N Medical Collage, Jodhpur
🇮🇳Jodhpur, RAJASTHAN, India
MDM hospital, Dr S N Medical Collage, Jodhpur🇮🇳Jodhpur, RAJASTHAN, IndiaDr Geeta SingariyaPrincipal investigator9414803554geetamanojkamal@gmail.com