PENG and LFCN Block Versus FIC Block for Multimodal Analgesia After Total Hip Replacement Surgery: a Retrospective Analysis Focused on Movement (Retro-PvF)

Completed

• Conditions: Regional Anesthesia Block; Regional Anesthesia; Total Hip Arthroplasty \(THA\); Total Hip Replacement Surgery
• Interventions: Procedure: PENG + LFCN block; Procedure: FIC block

• Registration Number: NCT06342102
• Lead Sponsor: Ospedale Edoardo Bassini

Brief Summary

Total hip arthroplasty is a major surgical procedure performed on a growing number of patients. Optimal pain control with limited muscle weakness is paramount for a swift initiation of physical therapy and ambulation, thus expediting hospital discharge. Amongst the many peripheral nerve blocks, FIB (fascia iliaca block) has been recommended as the block of choice by many international guidelines since it offers the best pain control with a relatively low risk of motor block. PENG (pericapsular nerve group) and its association with LFCN (lateral femoral cutaneous nerve) has been proposed as an effective alternative that offers comparable, If not better, pain control with a considerably lower risk for motor block compared to FIB. Given the novelty of this block, there are few published papers on the subject, mostly case series or case reports thus justifying the need for retrospective study.

Detailed Description

The primary outcome was the degree of residual quadriceps femoris muscle paresis assessed with the MRC (medical research council) scale at 6 hours between PENG and LCFN. The secondary outcomes were NRS (numeric rating scale) at 6,12, 24 hours, total opioid consumption expressed as milligrams of morphine equivalents (MME), time to first rescue opioid and time to first postoperative ambulation.

Study Timeline

• Study Start: 2024-03-26
• Study First Submitted: 2024-03-26
• Study First Submitted QC: 2024-03-26
• Primary Completion: 2024-04-01
• Study First Posted: 2024-04-02
• Study Completion: 2024-04-30
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-18
• Last Update Posted: 2025-03-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

• elective total hip replacement surgery for non-traumatic hip disease,
• age over 18 years,
• complete clinical chart including type of peripheral nerve block performed,
• signed consent form for spinal anesthesia and peripheral nerve block.

Exclusion Criteria

• preoperative opioid therapy,
• having received a peripheral nerve block other than PENG + LFCN or FICB,
• having received general anesthesia,
• incomplete chart,
• documented muscle weakness
• deviation from the established post-operative analgesia protocol.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
PENG + LFCN Block	PENG + LFCN block	group in which PENG + LFCN Block was performed
FIC Block	FIC block	group in which FIC Block was performed

Primary Outcome Measures

Name	Time	Method
Movement of the lower limb affected by surgery	6 hours after surgery	The Medical Research Council (MRC) Muscle Strength Scale (ranging scale from 0 to 5 0= no visible contraction, 5=normal power) was used to assess the degree of residual quadriceps femoris muscle paresis 6 hours postoperatively.

Secondary Outcome Measures

Name	Time	Method
Morphine Milligram Equivalents (MME) of "pro re nata" (PRN) opioid doses	12 hours after surgery	we studied the effect of Regional anesthesia on opioid-sparing
pain control	24 hours after surgery	pain assessment with Numeric Rating Scale (NRS): a 0-10 scale, with zero meaning "no pain" and 10 meaning "the worst pain imaginable"

Trial Locations

Locations (1)

ASST Nord Milano - Ospedale E. Bassini; 🇮🇹 Cinisello Balsamo, Italy/Milano, Italy