Analgesic Comparison of PENG/LFCN to FICB for Total Hip Arthroplasty

Study Overview
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Brief Summary
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This study compares 2 commonly used interventions (regional pain blocks) used in hip arthroplasty for pain control. One of the interventions is newer and not widely established.

Detailed Description
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This study will compare the FICB to the PENG/LFCN blocks. Patient reported pain scores on a verbal numeric rating scale will be utilized and recorded in the PACU and postoperatively at 3, 6, 12, 18, 24, 36 and 48 hours after patient arrival in the PACU. Additionally, opioid consumption will be converted to morphine milliequivalents and compared between groups.

Official Title
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Analgesic Comparison of Pericapsular Nerve Group (PENG) Block and Lateral Femoral Cutaneous Nerve (LFCN) Block to Fascia Iliaca Compartment Block (FICB) in Patients Undergoing Primary Total Hip Arthroplasty (THA).

Conditions
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Analgesia

Intervention / Treatment
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* Procedure: Pericapsular Nerve Group Block with Lateral Femoral Cutaneous Nerve Block
* Procedure: Fascia Iliaca Compartment Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Eligibility criteria for the study were: age 40-80, Physical Status I-III, BMI less than 40 kg/m2, ability to read and speak English, able to sign their own consent form and undergoing elective primary total hip arthroplasty. Exclusion Criteria: Patients were excluded if they were chronically prescribed opioids for a condition unrelated to their surgical hip pain, were deemed Physical Status 4 or higher, had an ongoing coagulopathy, had any infection near the site of injection, had an allergy to local anesthetics, deemed to have diabetic neuropathy, deemed to have a contraindication to spinal anesthesia or were unable to report their pain scores reliably (as in severe dementia or similar).

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized, single-blinded, controlled study
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: pericapsular nerve group block and lateral femoral cutaneous nerve block<br>Nerve blocks | Procedure: Pericapsular Nerve Group Block with Lateral Femoral Cutaneous Nerve Block<br>* Local anesthetic will be deposited along the lower pelvis to block 3 nerves that innervate the anterior hip capsule<br>Procedure: Fascia Iliaca Compartment Block<br>* Local anesthetic is deposited between the fascia iliaca and the internal oblique muscle in an attempt to block 3 nerves that innervate the hip.<br>* Other names: Suprainguinal Fascia Iliaca Block;|
| Active Comparator: fascia iliaca compartment block<br>Nerve block | Procedure: Pericapsular Nerve Group Block with Lateral Femoral Cutaneous Nerve Block<br>* Local anesthetic will be deposited along the lower pelvis to block 3 nerves that innervate the anterior hip capsule<br>Procedure: Fascia Iliaca Compartment Block<br>* Local anesthetic is deposited between the fascia iliaca and the internal oblique muscle in an attempt to block 3 nerves that innervate the hip.<br>* Other names: Suprainguinal Fascia Iliaca Block;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Verbal Numeric Pain Score Comparison of Pericapsular Nerve Group (PENG) Block and Lateral Femoral Cutaneous Nerve (LFCN) Block to Fascia Iliaca Compartment Block (FICB) in Patients Undergoing Primary Total Hip Arthroplasty (THA). | Patient reported pain scores will be monitored and tracked and compared. | 1 year |