Efficacy Of ultrasound -guided Pericapsular nerve group (PENG) Block vs Iliopsoas plane block in pain relief in the adult Patients with Hip fractures attending to the Emergency Department; A Double-blinded Randomized controlled trial.
试验速览
- 阶段
- 4 期
- 状态
- 尚未招募
- 入组人数
- 42
- 试验地点
- 1
- 主要终点
- To compare the efficacy of USG-guided Iliopsoas plane block (IPB) with USG-guided pericapsular nerve block (PENG) in reducing pain,in adult patients with hip fractures presenting to the Emergency department.
研究概览
简要总结
Hip fractures are frequently encountered in patients who present to the Emergency department following road traffic accidents, Self fall and other modalities of trauma. It is associated with high morbidity, in terms of pain encountered by patients and mortality. Compounded by a wide array of complications associated with Hip fractures such as severe excruciating pain, hypovolemic shock, vascular and nerve injuries makes their treatment challenging.In the emergency department, apart from the initial pain reported by patients due to the injury, these patients will undergo further traction and movements of the fractured segment, which further exacerbate the pain. This has been overcome with intravenous analgesia and regional analgesia like ultrasound -guided pericapsular nerve block (PENG) but these causes adverse effect like quadriceps weakness and higher level of analgesics but recently motor sparing ultrasound -guided Iliopsoas plane block (IPB) a novel method for hip analgesia whose efficacy is not well established yet . The aim of this study is to see the effect of the Iliopsoas plane block in the control of the hip fracture pain as well as to compare the effectiveness of the IPB compared to PENG.
Although studies have utilized Iliopsoas plane block for analgesia in reliving post operative pain in hip fracture or post hip arthroplasty, the efficacy and safety of the same and the feasibility of performing it in an emergency setup in patients with Hip fractures and comparison study with pericapsular nerve block is yet to be evaluated as a randomized controlled trial, to the best of our knowledge.
Furthermore, once established, the routine usage of it in Hip fracture patients as a part of a multimodal approach to lessen pain without increasing the complications of multiple intravenous analgesics.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant and Outcome Assessor Blinded
入排标准
- 年龄范围
- 18.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •All adult patients more than 18 years of age with hip fractures 1 Head of femur fractures 2 Neck of femur fractures 3 Intertrochanteric fractures 4 Sub trochanter fractures 5 Acetabular fractures And NRS score of greater than 4 at the site of hip injury.
排除标准
- •1 Known allergy to amide-type local anaesthetics , NSAIDS,Tramadol and fentanyl.
- •2 Pregnancy 3 Institutionalized individuals and prisoners 4 Unable to give consent due to dementia or altered mental status 5 Requiring immediate surgical intervention 6 Patents with suspected vascular injury in ipsilateral limb 7 Signs of infection or laceration at the injection site 8 The patient had undergone surgery on the same hip prior to thisfracture 9 History of chronic pain, chronic use of analgesics 10 History of substance abuse 11 Bilateral hip injuries 12 History of any bleeding diathesis 13 Patient has been transferred from the inpatient facility of anotherhospital after the surgical repair of a hip fracture.
- •14 hip dislocation.
结局指标
主要结局
To compare the efficacy of USG-guided Iliopsoas plane block (IPB) with USG-guided pericapsular nerve block (PENG) in reducing pain,in adult patients with hip fractures presenting to the Emergency department.
时间窗: 30 minutes 1 Hour 2 hours 3 hours
次要结局
- To compare the total amount of rescue analgesia requirements between ultrasound-guided Iliopsoas plane block (IPB) and ultrasound -guided Pericapsular nerve group (PENG) block in Patients with Hip fractures presenting to the Emergency department.(3 hours)
- To assess the complications of USG-guided Iliopsoas plane block and compare it with complications of PENG blocks within patients with Hip fractures presenting to the Emergency Department.
研究者
Dr Joshwa ajay J
Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)