PENG vs. QLB vs. Lumbar ESPB in Total Hip Surgery

Not Applicable

Recruiting

• Conditions: ESPB; Total Hip Surgery; Pericapsular Nerve; Quadratus Lumborum
• Interventions: Procedure: Lumbar ESPB Technique; Procedure: PENG block Technique; Procedure: Transmuscular QLB-t block Technique

• Registration Number: NCT05600244
• Lead Sponsor: Kafrelsheikh University

Brief Summary

The aim of this study is to compare between Pericapsular Nerve Group Block, Erector Spinae Plane Block and Quadratus Lumborum Block for managing acute postoperative pain in patients undergoing total hip surgeries under spinal anesthesia.

Detailed Description

Total hip surgeries are one of the most common major orthopedic procedures to improve patient's functional status and quality of life. However, despite these advantages, the immediate postoperative period can be associated with severe pain that delays mobilization and increases hospital stay and the risk of thromboembolic events.

Various methods are used for postoperative pain management. Intravenous opioid agents are among them, but they may cause undesirable side effects, such as respiratory depression, sedation, constipation, allergic reaction, nausea, and vomiting. Thus, alternative techniques are preferred.

Study Timeline

• Study First Submitted: 2022-10-26
• Study First Submitted QC: 2022-10-26
• Study First Posted: 2022-10-31
• Study Start: 2022-12-15
• Status Verified: 2023-09
• Last Update Submitted: 2023-09-03
• Last Update Posted: 2023-09-06
• Primary Completion: 2023-10-10
• Study Completion: 2023-10-10

Recruitment & Eligibility

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

Inclusion Criteria

• Age 18-65 years
• Both genders
• Body mass index < 40 kg/m^2
• American Society of Anesthesiologists (ASA) physical status I-III
• Posted for total hip surgeries under spinal anesthesia

Exclusion Criteria

• The presence of contraindications or allergy to local anesthetic agents
• Chronic use of opioids or corticosteroids
• Infection at the puncture site
• Coagulopathy
• Psychiatric disorders (dementia or cognitive impairment.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Lumbar ESPB Technique	Lumbar ESPB Technique	Patients will receive lumbar erector spinae plane block using 30 ml bupivacaine 0.25%
PENG block Technique	PENG block Technique	Patients will receive ultrasound-guided Pericapsular Nerve Group Block using 30 ml bupivacaine 0.25%.
Transmuscular QLB-t block Technique	Transmuscular QLB-t block Technique	Patients will receive transmuscular quadratus lumborum block using 30 ml bupivacaine 0.25%

Primary Outcome Measures

Name	Time	Method
Total amount of rescue analgesia	24 hours postoperatively	Total amount of rescue analgesia in the form of morphine will be recorded

Secondary Outcome Measures

Name	Time	Method
First analgesic request	24 hours Postoperatively	The time to first request of rescue analgesia will be recorded
Adverse events	48 hours Postoperatively	Adverse events will be recorded (e.g., nausea, vomiting, hypotension and bradycardia)
Pain level	48 hours Postoperatively	Pain level will be evaluated using numeric rating analogue scale (NRS), which ranges from 0 to 10 points, with 0 indicating no pain, 1-3 indicating mild pain, 4-6 indicating moderate pain, and 7-10 indicating severe pain.

Trial Locations

Locations (1)

Mohammad Fouad Algyar; 🇪🇬 Tanta, ElGharbiaa, Egypt