Comparison of two types of nerve blocks for analgesia following hip surgeries

Completed

• Conditions: Medical and Surgical,

• Registration Number: CTRI/2023/04/051796
• Lead Sponsor: Dr Sripada G Mehandale

Brief Summary

Patients satisfying the selection criteria will be enrolled and informed written consent will be obtained. NPO guidelines and premedications will be followed as per standard guidelines. NRS will be explained to the patient before the surgery. After shifting to operation theatre, baseline vitals will be noted. Group allocation will be done as per the random numbers generated by the computer.

Group P will receive ultrasound-guided PENG with LFCN block

Group F will receive ultrasound-guided suprainguinal FIB



The subarachnoid block will be given to the patient in sitting position with a 25 gauge Quincke-Babcock needle with 0.5% Inj. Bupivacaine (hyperbaric). The amount of drug for SAB will be decided by the anaesthesiologist in charge of the patient according to the need of the surgical procedure to provide effective anaesthesia throughout the procedure.



At the end of the procedure, the sensory and motor level of spinal anaesthesia will be assessed and noted.

The sensory level of the blockade will be assessed in the midclavicular line bilaterally with a cotton swab dipped in spirit and the highest dermatome blocked will be noted.

The motor level of the blockade will be assessed by the modified Bromage scale.



As per group allocation, either of the blocks will be given.

Group P: A solution of 0.4ml/kg of 0.25% bupivacaine with 1 mcg/kg of dexmedetomidine will be prepared.

PENG block: 0.3 ml/kg of 0.25% bupivacaine with 1 mcg/kg of dexmedetomidine will be given.

LFCN block: The remaining solution will be given.

Group F: 0.4 ml/kg of 0.25% bupivacaine with 1 mcg/kg of dexmedetomidine will be given for FIB.



After performing the block, the patient will be shifted to PACU.

The following parameters will be recorded at 0, 30, 60 min and thereafter 2nd, 4th, 6th, 8th, 12th and 24th hour in the post-operative period:

- NRS score for pain at rest and while flexing and extending hip joint

- Heart rate

- SBP, DBP and MAP

- Sedation with Brussels’ sedation score

- Level of sensory blockade due to spinal anaesthesia till it regresses to T12 (just above inguinal ligament)

- Lower limb motor power on the opposite side till full motor recovery from spinal anaesthesia (modified Bromage scale score - 6)

- Quadriceps muscle power on both sides

- Any adverse effects including nausea, vomiting, restlessness, urinary retention and treated appropriately.

- Patient satisfaction with NRS at 24 hours

- Time to first rescue analgesia – It is the time interval between the time at which the PENG with LFCN block or FIB is performed and the time at which first rescue analgesia is given.



If NRS for pain >5 or whenever patient demands, rescue analgesia with Inj. Tramadol 0.5 mg/kg bolus will be given intravenously and recorded along with a pain score at that time.

Detailed Description

Not available

Study Timeline

• Study Start: 2023-04-25
• Last Update Posted: 2023-10-16

Recruitment & Eligibility

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

Inclusion Criteria

Patients aged more than 18 years undergoing hip surgeries American Society of Anaesthesiologist Physical Status 1 2 and 3.

Exclusion Criteria

Patients undergoing multiple procedures, including bone grafting from other sites Patients with other fractures like distal femur, tibia and fibula Patients allergic to drugs used in the study History of long-term opioid or other analgesic consumption Patients with bleeding or coagulation disorders Patients with any neurological or musculoskeletal disorders Any contraindication for the blocks used in the study Infection or lesion at the site of block Patients with heart block, hypotension, bradycardia, cardiac failure.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The intensity of pain in the first 24 hours measured with NRS	24 hours

Secondary Outcome Measures

Name	Time	Method
Time to first rescue analgesia	Total dose of analgesics required in the first 24 hours post-surgery

Trial Locations

Locations (1)

KS Hegde Medical Academy; 🇮🇳 Kannada, KARNATAKA, India

KS Hegde Medical Academy

🇮🇳Kannada, KARNATAKA, India

Gayathri Annaselvam

Principal investigator

9362974182

gayathriannaselvam@gmail.com