Effects of Pericapsular Nerve Group Block on Postoperative Recovery for Total Hip Arthroplasty

Not Applicable

Recruiting

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

• Registration Number: NCT06183528
• Lead Sponsor: Umraniye Education and Research Hospital

Brief Summary

The hypothesis of this study is that patients who undergo PENG block in before Total Hip Artroplasthy (THA) surgery with spinal anesthesia will have reduced postoperative pain scores, less need for opioid analgesics and earlier mobilisation.

Detailed Description

This prospective randomised controlled study included a total of 60 patients aged 40-85 years who underwent THA surgery under spinal anaesthesia. Patients were divided into two groups as PENG block (n:30) and non-PENG block (n:30). PENG block was placed in the fascial plane between the pseudotendon and pubic ramus with USG in-plane technique, 20 ml of 0.5% bupivacaine was administered and surgery was initiated. The primary outcome of the study was to investigate the effect of preoperative PENG block application on postoperative pain, opioid requirement, mobilisation time, hip joint patency and length of hospital stay in patients undergoing THA surgery. The secondary outcome was to investigate the effect of PENG block on perioperative haemodynamics and postoperative side effects.

For multimodal analgesia, 10 ml 0.5% bupivacaine + 10 ml 2% lidocaine is infiltrated into the surgical wound incision line by the surgical team at the end of surgery. After tramadol 50 mg loading with PCA device, a basal rate of 5-10 mg/hour (20 mg bolus dose + 30 minutes lock time) is given with paracetamol 10 mg/kg iv (8 hours interval).

Study Timeline

• Study Start: 2023-09-01
• Study First Submitted: 2023-11-30
• Study First Submitted QC: 2023-12-13
• Study First Posted: 2023-12-27
• Status Verified: 2024-10
• Primary Completion: 2024-10-10
• Last Update Submitted: 2024-10-10
• Last Update Posted: 2024-10-14
• Study Completion: 2024-12-08

Recruitment & Eligibility

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

Inclusion Criteria

• THA performed by posterior approach
• 40-85 age range
• ASA 1-3

Exclusion Criteria

Under 40 years of age, over 85 years of age,

• ASA 4 and above,
• Cognitive impairment (Alzheimer's disease, dementia, delirium etc.),
• Hip fracture,
• Application site infection,
• Allergy to local anaesthetic agents,
• Patients are non-consenting patients.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
non-PENG group	Pericapsular Nerve Group (PENG) Block	group non-PENG, surgery was started without PENG block after spinal anaesthesia.
PENG group	Pericapsular Nerve Group (PENG) Block	PENG block was placed in the fascial plane between the pseudotendon and pubic ramus with USG in-plane technique, 20 ml of 0.5% bupivacaine was administered after spinal anaesthesia.

Primary Outcome Measures

Name	Time	Method
mobilisation time	24 -48 hours	walking 5 steps with walker
postoperative pain score	recovery room 30 min, 12., 24. and 48. hours in the postoperative period	VAS pain score
hip joint patency	24. hours	Measurement of joint movement angle with goniometer (angle)
total opioid consumption	48 hours	Tramadol total usage (mg)

Secondary Outcome Measures

Name	Time	Method
Perioperative haemodynamic data	T1: 30 minutes (min) after spinal anesthesia, T2: at the end of the surgical procedure, T3: at 30 minutes after recovery	heart rate, mean arterial pressure
PENG block side effects	The first 48 hours after performing the PENG block	motor block, nausea, vomiting, anaphylaxis, nerve damage
length of hospital stay	day	hospitalization and discharge time for surgery

Trial Locations

Locations (1)

UmraniyeERH; 🇹🇷 Istanbul, Umraniye, Turkey