Analgesic Efficacy of USG Guided Pericapsular Nerve Group Block Versus Intravenous Nalbuphine Hydrochloride In Patients of bony hip injuries: A Randomised Control Trial

Completed

• Conditions: Medical and Surgical,

• Registration Number: CTRI/2021/04/032715
• Lead Sponsor: Aiims Bhubaneswar

Brief Summary

Hip fractures are a harrowing and dangerous orthopaedic emergency that commonly presents to the emergency department.

These painful hip fractures are often managed with opioid analgesics like IV morphine or nalbuphine.

But most of them are undermedicated in an overcrowded ED setup with limited resources to monitor as there are a lot of undesirable adverse effects like respiratory depression, bradycardia, hypotension and delirium, which gets aggravated especially if used in older patients.

An equally effective alternative to IV opioids can be PENG block which is a peripheral nerve block.

The PENG block was derived from the femoral nerve’s articular branches, obturator nerve, and accessory obturator nerve that provide sensory innervation to the anterior capsule of the hip joint. It was developed as a safe and potentially more effective alternative to femoral nerve block (FNB) and fascia iliaca block (FIB) for hip injuries.

As the injection targets the terminal branches of sensory nerves, it has only a motor-sparing effect facilitating early mobilization.

There have only been two case series about PENG block available in the literature, but no RCT has yet been done.

This RCT can set a milestone in managing inadequate analgesia in hip fractures in ED set up and better patient compliance.

Detailed Description

Not available

Study Timeline

• Study Start: 2021-04-15
• Study Completion: 2022-09-19
• Last Update Posted: 2022-11-19

Recruitment & Eligibility

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

Inclusion Criteria

patients presenting with traumatic injuries to the hip and radiologically confirmed to be a 1.fracture of surgical neck of the femur 2.intertrochanteric fracture of femur 3.sub capital fracture of the femur 4.fracture of acetabulum 5.fracture of the pubic ramus 6.patients with NRS pain score≥5.

Exclusion Criteria

1.Infection over the skin at the site of block 2.The shaft of femur fracture 3.Allergic to local anesthetic 4.Coagulopathy 5.Pregnancy 6.Altered mental status 7.Hip Dislocation 8.patient not giving consent 9.patients who received analgesic before the block 10.Associated with other bony injuries(except the inclusion criteria).

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Numerical rating scale (NRS Scale)	Numerical rating scale (NRS Scale)baseline,30 mins,1 hour,2 hour,4 hour,6 hour

Secondary Outcome Measures

Name	Time	Method
To determine the need for rescue analgesia in both arms.	6 hours,12 hours
To study the adverse effect in both the arms.	30 mins,2 hours,4 hours, 6hours, 12 hours

Trial Locations

Locations (1)

AIIMS Bhubaneswar; 🇮🇳 Khordha, ORISSA, India

AIIMS Bhubaneswar

🇮🇳Khordha, ORISSA, India

DR SANGEETA SAHOO

Principal investigator

9556547655

drsangeeta.asth@gmail.com