Sonography-guided Pericapsular Never Group Block for Hip Arthroplasty

Study Overview
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Brief Summary
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In this study, the investigator will examine the efficacy of Pericapsular nerve group (PENG) block in hip arthroplasty as a post-operative pain management technique, study the analgesia, opioid-sparing effects and motor-blocking effects of the PENG block

Detailed Description
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PENG Block group (PG) will receive 0.5%Ropivacaine in 20 ml of saline. Sham Block group (SG) will receive 20 ml of saline Patient will be sedated with IV midazolam before nerve block. After peripheral nerve block ,general anesthesia will be conducted using sufentanyl, propofol and rocuronium for induction and propofol and sevoflurane for maintenance. Tests will be operated after procedure，and recorded up to 48 hours after surgery.

Official Title
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Sonography-guided Pericapsular Nerve Group Block for Hip Arthroplasty

Conditions
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Arthroplasty, Nerve Block, Analgesia

Intervention / Treatment
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* Procedure: pericapsular nerve group block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled for hip arthroplasty Exclusion Criteria: allergy to local anesthetics infection at the injection site patients receiving opioids for chronic analgesic therapy other lower limb neuropathies inability to comprehend visual analog scale (VAS) preexist cognitive dysfunction

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pericapsular nerve group block<br> | Procedure: pericapsular nerve group block<br>* Branches of both the FN and ON provide innervation to the anterior hip capsule. High and low branches of FN provided the majority of innervation to the lateral and superomedial hip capsule. The AON innervates the medial capsule.Both of the nerve close to the periosteum between the iliopubic eminence and AIIS ,by using ultrasound guided technique,these sites can be potential bony landmarks provid approch to the nerve group.<br>|
| Placebo Comparator: Saline placebo group<br> | Procedure: pericapsular nerve group block<br>* Branches of both the FN and ON provide innervation to the anterior hip capsule. High and low branches of FN provided the majority of innervation to the lateral and superomedial hip capsule. The AON innervates the medial capsule.Both of the nerve close to the periosteum between the iliopubic eminence and AIIS ,by using ultrasound guided technique,these sites can be potential bony landmarks provid approch to the nerve group.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Highest VAS score in recovery room | Highest VAS score reported in recovery room,patient will be asked questions to measure the highest VAS score experienced in the recovery room before discharge. If the patient had a unexpected long stay at recovery room, the question will be asked at the time point 2 hours after surgery end | before recovery room discharge(up to 2 hours after surgery end) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAS at rest | VAS pain score while patient at rest | day0 ,day1 ,day2 | 
| highest VAS at period | highest VAS reported at follow up period | day0 ,day1 ,day2 | 
| quadriceps strength | Measure quadriceps strength peak value at different time point | day0 , day1 ,day2 | 
| total opioid consumption |  | up to 2 days after surgery | 
| PONV rate | postoperative nausea and vomit | day0 ,day1 ,day2 | 
| Fall incident happened | Record the fall incident happened,fall is defined as patinent accidently fall to the ground. | up to 2 days after surgery | 
| Nerve block range | A cotton yarn with ethanol will be put on both the surgical and nonsurgical leg to evaluate the cold sensation lost after nerve block.Skin sensation lost will be tested at lateral thigh,medial thigh,front thigh and lateral claf | day0 , before discharge from PACU(up to 2 hours after surgery end) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pericapsular Nerve Group, PENG, hip arthroplasty, Postoperative analgesia, quadriceps strength