Effects of Pericapsular Nerve Group Block Applied in Patients Undergoing Hip Fracture Surgery.

Not Applicable

Recruiting

• Conditions: Pain, Postoperative; Hip Fractures
• Interventions: Procedure: Pericapsular Nerve Group (PENG) Block

• Registration Number: NCT06183541
• Lead Sponsor: Umraniye Education and Research Hospital

Brief Summary

In this study, it was aimed to compare the multimodal analgesia application or the pericapsular nerve group (PENG) block methods in patients undergoing hip surgery. The effectiveness and benefit rate of the PENG block in postoperative pain will be evaluated.

Postoperative pain, need for additional analgesia, range of motion of the hip joint, mobilization time, length of hospital time and adverse events in patients undergoing hip fracture surgery with and without PENG block will be investigated.

Detailed Description

This prospective randomised controlled study included a total of 70 patients aged 30-85 years who underwent hip fracture surgery under spinal anaesthesia. Patients were randomly divided into two groups using the sealed envelope method, Group I: those who received PENG block (n:35) and Group II:Those who did not receive PENG block (control group) (n: 35).

All patients will undergo hip fracture surgery by the same surgical team. Each patient will be informed about the procedure to be performed during anesthesia and surgery, and signed informed consent will be obtained before the procedure.Patients in Group I who will undergo the PENG block method; Before surgery, after spinal anesthesia, PENG block is performed under sterile conditions under ultrasonography guidance. With the patient supine, a 2-5 MHz, low-frequency, curvilinear probe is placed in the transverse plane medial to the anterior inferior iliac spine (AIIS), with the medial end of the probe rotated approximately 45° counterclockwise to align with the superior pubic ramus.

With the PENG block, an 80 mm block needle is placed in the fascial plane between the psoas tendon and the pubic ramus and 20 ml of 0.5% bupivacaine is administered.

As for the patients in Group II (control group); It is a routine practice at the end of surgery; 10 ml 0.5% bupivacaine + 10 ml 2% lidocaine is infiltrated into the surgical area by the surgical team.

For routine postoperative multimodal analgesia, intravenous PCA (patient controlled analgesia) was administered to patients in both groups with tramadol 50 mg at a basal rate of 10 mg / hour after loading (20 mg bolus dose + 30 minutes lock time) and paracetamol 10 mg / kg iv. (Given every 8 hours)

Study Timeline

• Study Start: 2023-11-21
• Study First Submitted: 2023-12-03
• Study First Submitted QC: 2023-12-13
• Study First Posted: 2023-12-27
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-11
• Last Update Posted: 2025-03-12
• Primary Completion: 2025-03-28
• Study Completion: 2025-05-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 70

Inclusion Criteria

• Patients who will undergo hip fracture surgery Women and men aged 30-85

Exclusion Criteria

• Patients under 30 years old, over 85 years old
• American Society of Anesthesiology (ASA) IV,
• Those with cognitive impairment (alzheimer, dementia, delirium, etc.)
• Those with application site infection
• Those who are allergic to local anesthetic substances
• Patients are non-consenting patients.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
PENG Block group	Pericapsular Nerve Group (PENG) Block	PENG block group; USG probe is placed on the transverse plane medial to the anterior inferior iliac spine (AIIS), the medial end of the probe is placed on the superior pubic It is rotated approximately 45° counterclockwise to align it with the ramus. For the PENG block, an 80 mm block needle is placed in the fascial plane between the psoas tendon and pubic ramus and 20 ml of 0.5% bupivacaine is administered after spinal anesthesia,
Control group	Pericapsular Nerve Group (PENG) Block	Control group; 10 ml 0.5% bupivacaine + 10 ml 2% lidocaine is infiltrated into the surgical area by the surgical team at the end of surgery

Primary Outcome Measures

Name	Time	Method
mobilisation time	postoperative 24-48 hours	take 5 steps with walker
postoperative pain score	30 min, 12th, 24th and 48th hours in the postoperative period	VAS pain score
Total opioid consumption	postoperative 48 hours	Tramadol (mg)

Secondary Outcome Measures

Name	Time	Method
length of hospital stay	between the time of hospitalization for the operation and discharge (day)	day
PENG block adverse events	between the time surgery starts and the 48th hour	motor block, nerve damage, hypotension, bradycardia

Trial Locations

Locations (2)

UmraniyeERH; 🇹🇷 Istanbul, Umraniye, Turkey

Umraniye Education and Research Hospital; 🇹🇷 Istanbul, Umraniye, Turkey