Peri-Capsular Nerve Group and Supra Inguinal Fascia Iliaca BLOCK for Analgesia and Ease of Positioning During Neuraxial Anesthesia in Hip Fracture Patients

Study Overview
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Brief Summary
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Severe pain associated with fractured hip often results in difficulty during positioning for spinal anesthesia (SA). Among many regional analgesic techniques, the fascia iliaca compartment block (FICB) is popular among anesthesiologists to provide immediate as well as postoperative analgesia in hip fractures. Recently, the pericapsular nerve group (PENG) block has been proposed to provide effective analgesia in hip fracture patients. However, comparative studies between PENG and FICB are lacking.

Official Title
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Comparison Between Peri-Capsular Nerve Group and Supra Inguinal Fascia Iliaca BLOCK for Analgesia and Ease of Positioning During Neuraxial Anesthesia in Hip Fracture Patients: A Randomized Clinical Trial.

Conditions
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Spinal Anesthesia, Hip Fractures

Intervention / Treatment
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* Procedure: suprainguinal fascia iliaca block
* Procedure: pericapsular nerve group block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 40 years and above with hip fracture with persistent pain and scheduled for surgery under spinal anesthesia (SA) Exclusion Criteria: any contraindications to SA or peripheral nerve blocks, history of ischaemic heart disease, patients on opioids for chronic pain and patients with significant cognitive impairment. Patients who had no pain while sitting by themselves (resting pain less than 4 on NRS) for SA without any support were also excluded.

Ages Eligible for Study
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Minimum Age: 40 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: FICB group<br>received ultrasound guided suprainguinal fascia iliaca block | Procedure: suprainguinal fascia iliaca block<br>* ultrasound guided suprainguinal fascia iliaca block<br>|
| Active Comparator: PENG group<br>received ultrasound guided pericapsular nerve group block | Procedure: pericapsular nerve group block<br>* ultrasound guided pericapsular nerve group block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NRS | In a Numerical Rating Scale (NRS), patients are asked to circle the number between 0 and 10, that fits best to their pain intensity. Zero usually represents 'no pain at all' whereas the upper limit represents 'the worst pain ever possible'. | 30 minute postoperative | 
| The ease of spinal positioning (EOSP) | The ease of spinal positioning (EOSP) was assessed on the scale of 0-3 (0 = unable to position, 1 = patient had abnormal posturing due to pain and required support for positioning, 2 = mild discomfort but does not require support for positioning, 3 = optimal condition where the patient was able to position himself without pain) | Thirty minutes after the blocks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| amount of tramadol used | number of rescue doses of tramadol will be recorded | 24 hours postoperatively |