PENG Block vs. ESP Block for Pediatric Hip Surgery

Study Overview
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Brief Summary
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The study compares the effectiveness and safety of the pericapsular nerve blockade vs. ESPB in pediatric patients who underwent hip surgeries.

Detailed Description
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The study compares the effectiveness and safety of the pericapsular nerve blockade vs. ESPB in pediatric patients who underwent hip surgeries. In addition, we aim to determine the optimal volume of local anesthetics needed to achieve a satisfactory level of analgesia.

Official Title
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PENG Block vs. ESP Block for Pediatric Hip Surgery. A Randomized, Prospective Double-blinded Clinical Trial.

Conditions
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Hip Dysplasia, Hip Injuries, Hip Fractures, Hip Disease

Intervention / Treatment
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* Drug: Pericapsular nerve group block using 0.2% ropivacaine
* Drug: Erector Spinae Plane Block using 0.2% ropivacaine
* Other: Standard care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - pediatric patients aged between 0-12 years who will undergo hip surgery Exclusion Criteria: a history of chronic pain use of gabapentin/pregabalin for > 3 months opioid use > 1 repeated opioid prescription in the last three months morbid obesity (BMI > 99th percentile) Infection at block application area coagulopathy

Ages Eligible for Study
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Minimum Age: 2 Months
Maximum Age: 12 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
Interventional Model Description: Three groups: Group I -control Group II - PENG block Group III - ESP block
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control group<br>regional anesthesia: spinal anesthesia - 0,1ml/kg 0,5% ropivacaine | Other: Standard care<br>* No erector spinae block and no pericapsular nerve group block<br>* Other names: No erector spinae block and no pericapsular nerve group block;|
| Active Comparator: Pericapsular nerve group block (PENG) group<br>regional anesthesia: spinal anesthesia - 0,1ml/kg 0,5% ropivacaine + PENG block - 0.5mL/kg 0.2% ropivacaine, max. 20mL | Drug: Pericapsular nerve group block using 0.2% ropivacaine<br>* Unilateral ultrasound guided pericapsular nerve block using 0.5mL/kg 0.2% Ropimol (max 20mL)<br>|
| Active Comparator: Erector Spinae Plane Block (ESPB) group<br>regional anesthesia: spinal anesthesia - 0,1ml/kg 0,5% ropivacaine + ESP block - 0.5mL/kg 0.2% ropivacaine, max. 20mL | Drug: Erector Spinae Plane Block using 0.2% ropivacaine<br>* Unilateral ultrasound guided erector spinae block using 0.5mL/kg 0.2% Ropimol (max 20mL)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| FLACC score | The FLACC scale or Face, Legs, Activity, Cry, Controllability Scale is used to assess pain for children between the ages of 2 months and seven years or individuals unable to communicate their pain. The scale is scored in a range of 0-10, with 0 representing no pain. | 48 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NLR | neutrophil-to-lymphocyte ratio | 48 hours after surgery | 
| PLR | platelet-to-lymphocyte ratio | 48 hours after surgery | 
| total opioid consumption | morphine equivalents in miligrams | 48 hours after surgery |