NLR and PLR Levels Following iPACK Block in Hip Arthroplasty

Phase 4

Recruiting

• Conditions: Hip Arthropathy; Hip Osteoarthritis; Hip Pain Chronic
• Interventions: Drug: 0.9% Sodium Chloride Injection; Drug: Ropivacaine 0.2% Injectable Solution

• Registration Number: NCT07023107
• Lead Sponsor: Poznan University of Medical Sciences

Brief Summary

Effect of PENG block on NLR and PLR following hip arthroplasty

Detailed Description

The NLR is a sensitive indicator of inflammation confirmed in numerous studies and has a predictive and prognostic value. NLR is a cheap, simple, fast-acting, readily available stress and inflammation parameter with high sensitivity and low specificity. Dynamic changes in the NLR precede the clinical state by several hours and may alert clinicians to the ongoing pathological process early. NLR is a new promising marker of cellular immune activation, an important indicator of stress and systemic inflammation. It opens a new dimension for clinical medicine, enabling a better understanding of the biology of inflammation, the linkage and antagonism between innate and adaptive immunity, and their clinical consequences for health and disease.

NLR is affected not only by surgical trauma but also by the method of anesthesia. In recent years, the influence of regional anesthesiology on reducing the inflammatory response after surgical procedures has been emphasized. However, there have been very few studies evaluating the effect of various methods of anesthesia on the NLR.

Study Timeline

• Status Verified: 2025-06
• Study First Submitted: 2025-06-08
• Study First Submitted QC: 2025-06-08
• Study First Posted: 2025-06-15
• Study Start: 2025-06-16
• Last Update Submitted: 2025-07-08
• Last Update Posted: 2025-07-11
• Primary Completion: 2026-07-31
• Study Completion: 2026-12-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Patients with ASA classification I-III
• Aged 60-100 years
• Who will be scheduled for hip arthroplasty under spinal anesthesia

Exclusion Criteria

• Patients who have a history of bleeding diathesis
• Take anticoagulant therapy
• History of chronic pain before surgery
• Multiple trauma
• patients unable to assess their pain (dementia)
• patients operated under general anesthesia
• patients having an infection in the region of the procedure
• the patient who does not accept the procedure

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Sham blocks	0.9% Sodium Chloride Injection	PENG block with 20ml of 0.9% sodium chloride
PENG block	Ropivacaine 0.2% Injectable Solution	PENG block with 20ml 0f 0.2% ropivacaine

Primary Outcome Measures

Name	Time	Method
Neutrophil-to-lymphocyte ratio	12 hours after surgery	Neutrophil to lymphocyte ratio (NLR) is used as a marker of subclinical inflammation. It is calculated by dividing the number of neutrophils by number of lymphocytes, usually from peripheral blood sample, but sometimes also from cells that infiltrate tissue, such as tumor.

Secondary Outcome Measures

Name	Time	Method
PLR	48 hours after surgery	Platelet-to-lymphocyte ratio
NLR	48 hours after surgery	Neutrophil-to-lymphocyte ratio
first need of opiate	48 hours after procedure	Time after surgery when the patient needs opiate for the first time
Opioid Consumption	48 hours after surgery	Total opiate consumption after surgery
Pain score	24 hours after surgery	NRS (Numerical Rating Scale) - ranging from 0 to 10, where 0 represents "no pain" and 10 represents the "worst pain imaginable"

Trial Locations

Locations (1)

Poznan University of Medical Sciences; 🇵🇱 Poznań, Poland