Comparing the postoperative analgesic effect between the ultrasound guided Pericapsular Nerve Group PENG block and Fascia Iliaca Compartment Block FICB in intertrochanteric hip fracture surgeries

This randomized double blinded clinical trial will be conducted at ESIC Medical College and Hospital Chennai, after approval from the institutional ethics committee. Informed written consent will be obtained from all the participants of the study. All the patients scheduled for elective intertrochanteric hip fracture surgeries between the age group 40 to 70 years of either sex  belonging to ASA 1,2 and 3 will be included in the study. On the day of surgery, spinal anaesthesia will be given for the surgery as per standard institutional protocol. Randomization will be done by a computer-generated table of random numbers. The allocation list will be generated and concealed in sealed envelopes. One envelope will be opened for each eligible candidate and the patient will be allocated to one of the two groups. The patient and the principal investigator will be blinded to this study. An Anaesthesiologist trained in these blocks will be performing the procedure. After surgery, under sterile aseptic precautions, patients in the Group A will receive an ultrasound guided pericapsular nerve group block using 0.25 percentage bupivacaine 28 ml and 8 mg of dexamethasone 2 ml. Patients in the Group B will receive an ultrasound guided Fascia Iliac compartment block using 0.25 percentage bupivacaine 28 ml, and 8 mg of dexamethasone 2 ml. Once the regional block is complete the patient will be shifted to the PACU post anaesthesia care unit for further observation. The study will start from the time the patient is shifted to PACU. The postoperative analgesia effect and other parameters such as heart rate, blood pressure, oxygen saturation spo2, first time of rescue analgesia, total opioid consumption, adverse effects, degree of range of motion by HARRIS HIP SCORE  at 0min, 15 min,30min,1 hour,2 hrs, 4hrs,8hrs,12 hrs and 24hrs after blockade. The injection of tramadol 1mg per kg mg intravenous sos will be considered as rescue analgesia if Visual Analogue Scale more than 4. Nausea, which is one of the most common side effects of tramadol, will be treated with injection Ondansetron 0.1 mg per kg  intravenous.