The PENG Block in Elective Hip Surgery and Its Effect on Postoperative Pain and Length of Stay: A Multidisciplinary Prospective Randomized Double-blind Controlled Trial.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Hôpital Fribourgeois
- Enrollment
- 151
- Locations
- 2
- Primary Endpoint
- Visual analogue scale (VAS)
Study Overview
Brief Summary
Effective postoperative pain management in elective hip surgery is crucial for the patients well-being, rapid mobilisation and potential reduction of length of stay. In addition to standard intravenous pain medication, anaesthetic blocks are reportedly effective. Recently, the PENG block, a pericapsular pain block without impairment of the motor function has been introduced in literature and performed at the investigator's hospital (HFR Fribourg, Switzerland) for total hip arthroplasty and surgical hip dislocation - the two most commonly performed elective hip surgeries.
As high-quality evidence on the effectiveness of this novel block is lacking, the investigator's objective is to evaluate the effectiveness of (1) patient-reported pain reduction, (2) total consumption of postoperative morphine, and the length of stay at the hospital.
Detailed Description
Forty patients undergoing total hip arthroplasty and 40 patients undergoing surgical hip dislocation will be enrolled in a prospective, double-blind, controlled trial performed at the investigator's hospital.
This study will be the first prospective study evaluating the potential of this pain block in elective hip surgery potentially affecting both patients' postoperative well-being and optimizing costs of the hospital by reducing length of stay.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Triple (Participant, Care Provider, Investigator)
Eligibility Criteria
- Ages
- 18 Years to 85 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Anterior total hip arthroplasty for hip osteoarthritis
- •Surgical hip dislocation for femoro-acetabular impingement (type cam-/pincer)
- •Age 16-85 years
- •American Society of Anesthesiologists (ASA) physical status 1 to 3
Exclusion Criteria
- •Patient refusal/no informed consent
- •Inability to give informed consent
- •Lateral approach for total hip arthroplasty
- •Bilateral procedure
- •Additional osteotomies of the femur and/or acetabulum
- •Previous hip & pelvis surgery
- •Chronic opioid users
- •Known allergy or intolerance to medications used in the trial (local anesthetic, opioid)
- •Infection at the injection site
- •Body mass index > 40kg/m2
- •Spinal anesthesia
Outcomes
Primary Outcomes
Visual analogue scale (VAS)
Time Frame: Reduction of postoperative pain in the first 24 hours after surgery
Using a ruler, the score is determined by measuring the distance (cm) on the 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from 0 to 10. A higher score indicates greater pain intensity
Secondary Outcomes
- Total morphine consumption (morphine equivalent dose)(Total consumption of postoperative morphine in the first 24 hours after surgery)
- Length of stay (days)(Length of stay at the hospital (in days) from the day of the surgery (day 0) to the day of discharge, up to a maximum of 7 postoperative days)
Investigators
Matthieu Hanauer
Attending surgeon, M.D.
Hôpital Fribourgeois