Continuous ultrasound Pericapsular nerve group block in comparison with ultrasound lumbar plexus block for postoperative pain Management in unilateral hip fracture: A Prospective, randomised, single blind controlled trial study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- To compare the mean postoperative pain score over 48 hours using numeric rating scale in patients receiving PENG block vs lumbar plexus block
研究概览
简要总结
The postoperative pain relief of the patients undergoing surgery for unilateral hip fracture can be done by various techniques. Multiple trials and a systematic review have described decrease in pain scores and opioid consumption while comparing postoperative regional analgesia to systemic analgesia. Regional anaesthesia is considered one of the safer modes in elderly patients to alleviate postoperative morbidity and mortality. Lumbar plexus block (psoas compartment block) under ultrasound guidance is a novel important modality for providing pain relief in hip fracture surgeries. One of the difficulties of effective regional analgesia of hip pain is the complex innervation of the joint. Sensory innervation of anterior capsule of hip includes articular branches of femoral, obturator and accessory obturator nerve, with a greater contribution by the high branches of femoral nerve. Pericapsular nerve group block (PENG) is a novel regional analgesia technique for postoperative pain management of hip fracture. It was first described (PENG) block in 2018 by using a low frequency curvilinear ultrasound probe to deposit local anaesthetic in the 2 musculofascial plane between the psoas tendon anteriorly and the pubic ramus posteriorly. It was successfully demonstrated that PENG block reduced pain score by a median of 7 points on a 10 points numerical rating scale in patients with hip fracture. PENG block is primarily ultrasound guided which targets the articular branches of femoral nerve, accessory obturator nerve. PENG block is also used for surgical anaesthesia to reduce dislocated hip, striping of varicose vein. The major limiting factor for PENG block is the use of ultrasound as it is not yet available to everyone particularly in developing countries. The present study aims to evaluate the effectiveness, efficacy and safety of PENG block in comparison with lumbar plexus block for postoperative pain management of hip fracture.
研究设计
- 研究类型
- Interventional
- 分配方式
- Computer generated randomization
- 盲法
- Participant Blinded
入排标准
- 年龄范围
- 20.00 Year(s) 至 80.00 Year(s)（—）
- 性别
- All
入选标准
- •America Society of Anaesthesiologists (ASA) status.
- •I and II Age between
- •80 years BMI.
- •35 kg/m2 Patients undergoing surgery for unilateral hip fracture.
排除标准
- •Patient refusal History of drug allergy to ropivacaine and fentanyl Coagulation disorders Cardiovascular, respiratory, and neurological illness Uncontrolled Diabetes Mellitus Local infection Systemic infection Aberrant anatomy of the landmarks Patients having haemodynamic instability Pregnancy and lactating mother Patients who fail to understand pain assessment and usage of PCA pump.
结局指标
主要结局
To compare the mean postoperative pain score over 48 hours using numeric rating scale in patients receiving PENG block vs lumbar plexus block
时间窗: 5 mins, 10 mins, 15 mins, 1 hour, 4 hours, 8 hours, 12 hours, 24 hours, 36 hours, 48 hours.
次要结局
- To evaluate the difference in motor power and patient satisfaction within the two groups and also note adverse effects, if any, in both groups(5 mins, 10 mins, 20 mins, 4 hours, at 2 hour intervals till 24 hours, 36 hours, and 48 hours)