Pericapsular Nerve Group Block Versus Caudal Block for Postoperative Pain Management in Pediatric Hip Surgery

Not Applicable

Completed

• Conditions: Pain, Postoperative

• Registration Number: NCT06563622
• Lead Sponsor: Benha University

Brief Summary

Children can experience substantial pain after hip operations, causing agitation, depression, and sleep disruption, which can have a negative impact on their health. Opioids are associated with several serious side effects that limits its use as solo agents for pain management. Regional blocks such as caudal Block (CB) and pericapsular nerve group (PENG) block in adjuvant with general anaesthesia are alternative perioperative analgesic techniques that lead to lesser side effects, including motor weakness, postoperative nausea and vomiting with decreased opioid consumption.

Detailed Description

Regional anesthesia is often used to prevent postoperative pain in pediatric surgery. Combined with general anesthesia (GA), ultrasound (US)-guided regional anesthetic approaches provide simple intraoperative pathway that reduced GA requirements, lower pain score with less impact on the respiratory or cardiovascular system

In pediatric surgery, caudal block (CB) is a low-cost, simple, and effective procedure for postoperative analgesia. CB is suggested for most surgeries in the lower body, primarily below the umbilicus. Although the well-established anesthetic properties of CB, its action terminates early in the postoperative period and it has a number of restrictions, such as anatomical abnormalities or infection at the injection site, that can prevent its use

PENG block is the plane lying between the psoas muscle and tendon and the ilio-pubic eminence. The single-shot PENG block has lately been reported in the cadaveric study and in the literature for perioperative pain management in hip surgery by aiming the articular arms of the accessory obturator nerve (AON), femoral nerve (FN), and obturator nerve (ON). The technical simplicity of imaging in traction-fixed patients and no need for multiple punctures made this blockage ideal for young pediatric patients. Unfortunately, there are no adequate studies regarding PENG block in patients younger than five years old.

This study was carried out to assess ultrasound-guided PENG block versus CB for their efficacy, safety and pain management in pediatric hip surgery.

Study Timeline

• Study Start: 2024-08-10
• Study First Submitted: 2024-08-13
• Study First Submitted QC: 2024-08-19
• Study First Posted: 2024-08-21
• Primary Completion: 2025-04-01
• Study Completion: 2025-04-20
• Status Verified: 2025-06
• Last Update Submitted: 2025-06-22
• Last Update Posted: 2025-06-26

Recruitment & Eligibility

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

Inclusion Criteria

• child aged 1- 7 years old
• American Society of Anesthesiologists (ASA) physical status I-II
• scheduled for elective hip surgery under general anesthesia

Exclusion Criteria

• parents/guardians refusal to participate
• known local anesthetic drug sensitivity,
• bleeding disorders,
• pre-existing infection at the block site, and
• the presence of major cardiac, renal, or hepatic disorders.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
pain score with FLACC	30 minutes postoperative, 1 hour postoperative, 2 hour postoperative, and 6 hours postoperative	(Face, Legs, Activity, Cry, and Consolability scale to assess pain in young children. Each category is scored on a 0-2 scale which results in a total score between 0 (lowest pain) and 10 (worst pain).

Secondary Outcome Measures

Name	Time	Method
The incidence of postoperative adverse effects	24 hours postoperative	including nausea , vomiting , localized hematoma, bradycardia, hypo-tension, and Pruritis.
the Time to first postoperative rescue analgesia	24 hours postoperative	it will be administered if the FLACC score is ≥ 4/10.
Total rescue analgesia consumption	24 hours postoperative	total dose of pethidine administrated as rescue opioid
The duration of the block	immediately after the intervention, up to 24 hours postoperative	from immediately after the block administration until the first postoperative rescue analgesia.
Parents satisfaction score	24 hours postoperative	using a 5- point Likert score (0 = very dissatisfied, 1=dissatisfied, 2 = neither satisfied nor dissatisfied, 3 = satisfied and 4 = very satisfied)

Trial Locations

Locations (1)

Samar Rafik Mohamed Amin; 🇪🇬 Banhā, Qalubia, Egypt