Application of Pericapsular Nerve Group (PENG) Block in Transurethral Resection of Bladder Tumors
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 68
- 试验地点
- 1
- 主要终点
- the percentage reduction in adductor muscle strength at 5, 10, 15, 20, 25, 30 minutes, and 3 hours after drug administration, compared to pre-administration levels.
研究概览
简要总结
This study aims to determine the efficacy and safety of the Pericapsular Nerve Group (PENG) block in preventing obturator nerve reflex during transurethral resection of bladder tumors.
详细描述
During transurethral resection of bladder tumors (TURBT), obturator nerve reflex is easily triggered during electrocautery. Currently, two primary methods are used to prevent obturator nerve reflex: deep neuromuscular blockade under general anesthesia and obturator nerve block. To date, no studies have confirmed the efficacy of the Pericapsular Nerve Group (PENG) block in preventing obturator nerve reflex.
This study recorded the percentage decrease in adductor muscle strength at various time points after the PENG block, the occurrence of intraoperative adductor muscle spasms, the duration of nerve block procedure, and the incidence of postoperative adverse events. The completion of this study could provide clinical evidence for selecting anesthesia methods in TURBT procedures and offer robust evidence-based support for relevant medical decisions by government health agencies.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Investigator)
入排标准
- 年龄范围
- 18 Years 至 79 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Aged 18 years or older;
- •Scheduled for TURBT for unilateral bladder tumor;
- •Able to understand and provide informed consent;
排除标准
- •Patients who refuse or are unable to provide informed consent;
- •Allergic to local anesthetics, insensitive to propofol or general anesthetics;
- •Pregnant women;
- •Severe liver dysfunction;
- •Evidence of infection at or near the proposed puncture site;
- •Any sensory or motor impairment of the lower limbs;
- •Recent (within 6 months) lower limb joint replacement surgery.
研究组 & 干预措施
PENG Group:Ultrasound-guided pericapsular nerve group (PENG) block.
A convex ultrasound probe (frequency 2-5 MHz) was positioned at the patient's inguinal ligament, with one end directed toward the anterior inferior iliac spine (AIIS), clearly visualizing the bony prominences of the iliopubic eminence and the AIIS. The needle tip was directed medially toward the pectineus muscle. Upon reaching the space between the pectineus muscle and the pubic bone, and after confirming the absence of blood on aspiration, 30 ml of 0.375% ropivacaine was injected.
干预措施: peng block (Procedure)
Control group : Ultrasound-guided obturator nerve block.
An ultrasound probe was positioned at the inguinal ligament, with the needle inserted parallel to the long axis of the probe. After confirming no blood upon aspiration, 15 ml of 0.375% ropivacaine was injected into the fascial plane between the adductor brevis and adductor magnus, as well as into the midportion of the adductor longus and adductor brevis muscles.
干预措施: obturator nerve block (Procedure)
结局指标
主要结局
the percentage reduction in adductor muscle strength at 5, 10, 15, 20, 25, 30 minutes, and 3 hours after drug administration, compared to pre-administration levels.
时间窗: 5, 10, 15, 20, 25, 30 minutes, and 3 hours post-administration
The percentage increase in adductor strength from preoperative to postoperative measurements divided by preoperative adductor strength is larger, reflecting a better nerve block effect and superior obturator nerve reflex inhibition.
次要结局
- Presence of obturator nerve reflex during surgery(During surgery)
研究者
Hongwei Shi
associate professor
Nanjing First Hospital, Nanjing Medical University