PENG vs Intra-articular Injection for Hip Arthroscopy

Not Applicable

Recruiting

• Conditions: Opioid Use; Acute Pain
• Interventions: Procedure: Intra-articular local anesthetic injection; Procedure: Pericapsular nerve group block

• Registration Number: NCT04698746
• Lead Sponsor: Bezmialem Vakif University

Brief Summary

Hip arthroscopy is a popular surgical method that is increasingly being used for both intraarticular and extraarticular hip surgeries. Postoperative acute pain is difficult to control in hip surgeries due to the complex nature of hip innervation and the large number of surgical interventions. Optimal treatment of postoperative pain in hip arthroscopy is very important to be able to perform rehabilitation, avoid opioid side effects and minimize unplanned re-hospitalization. Regional anesthesia techniques are widely used because of their proven efficacy in post-surgical pain management and their safety profile that ultimately contributes to early recovery. Many regional techniques such as neuraxial blocks, lumbar plexus block, femoral nerve block, fascia iliac block and intraarticular local anesthetic injection have been used for the treatment of acute postoperative pain.

Femoral nerve and fascia iliac blocks have shown good results for long-term post-surgery analgesia. However, the obturator nerve and accessory obturator nerve should be targeted to achieve more effective perioperative pain control. There are studies reporting that pericapsular nerve group block (PENG), which has been defined in recent years, provides effective perioperative analgesia in hip surgeries. In this study, we aim to compare the effectiveness of PENG block and intra-articular local anesthetic injection in hip arthroscopy.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-01-05
• Study First Submitted QC: 2021-01-05
• Study First Posted: 2021-01-07
• Study Start: 2021-01-20
• Status Verified: 2024-01
• Last Update Submitted: 2024-01-22
• Last Update Posted: 2024-01-23
• Primary Completion: 2024-03
• Study Completion: 2024-04

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 72

Inclusion Criteria

• American Association of Anesthesiologists (ASA) physical status I - III
• BMI 20 to 35 kg / m2
• Patients scheduled for elective hip arthroscopy
• Able to provide informed consent.

Exclusion Criteria

• Patients who refuse to participate in the study,
• Coagulopathy,
• Sepsis,
• Hepatic or renal insufficiency,
• Pregnancy
• Allergy to local anesthetic drugs,
• Chronic pain condition requiring opioid intake at home,
• BMI above 40.
• History of psychiatric diseases needing treatment.
• Failure of nerve block
• Substance abuse history
• Hip revision surgery
• Underlying neurologic disorder affecting pain perception.
• Angina, heart attack, heart failure
• Kidney or hepatic insufficiency
• Stroke
• Gastrintestinal bleeding history

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intra-articular local anesthetic injection	Intra-articular local anesthetic injection	At the end of the surgical case, a total of 10 ml 0.5% bupivacaine + 2 mg dexamethasone + 9.5 ml isotonic saline injection intra-articularly.
Ultrasound guided pericapsular nerve group block	Pericapsular nerve group block	Injection of 15 ml 0.5% bupivacaine + 2 mg dexamethasone + 14.5 ml isotonic saline mixture between iliopubic eminentia and psoas tendon under ultrasound guidance

Primary Outcome Measures

Name	Time	Method
Postoperative opioid consumption	up to the first 24 hours postoperatively	Total amount of morphine consumption during the first 24 hours after surgery. Patient controlled analgesia to be inserted.

Secondary Outcome Measures

Name	Time	Method
Pain intensity score	0.5, 1, 3, 6, 12, 24 hours postoperatively.	Postoperative pain assessed with verbal rating scale (VRS 0: no pain 10:pain as bad as can be ) at 0.5, 1, 3, 6, 12, 24 hours postoperatively.
Postoperative nausea and vomiting	up to the first 24 hours postoperatively	Nausea and vomiting intensity score measured by numeric rank score (0:no nausea and no vomiting, 1: have nausea, no vomiting, 2: once vomiting, 3: two or more vomiting).
Patient satisfaction	at the end of 24 hours postoperatively	Patient satisfaction measured using a numeric rating scale 0 to 10 (0 = unsatisfied; 10 =very satisfied)
First rescue analgesic time	up to the first 24 hours postoperatively	The investigators will collect time to first rescue analgesic consumption in each group

Trial Locations

Locations (1)

Bezmialem Vakıf University; 🇹🇷 Istanbul, Turkey