PENG and LFCN Block Versus FIC Block for Multimodal Analgesia After Total Hip Replacement Surgery: a Retrospective Analysis

Study Overview
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Brief Summary
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Background: Optimal pain control with limited muscle weakness is paramount for a swift initiation of physical therapy and ambulation. Fascia iliaca compartment block (FICB) has been recommended since it offers the best pain control with low risk of motor block. Pericapsular nerve group block (PENG) with lateral femoral cutaneous nerve (LFCN) block has been proposed as an effective alternative to FICB that offers similar pain control with a considerably lower risk of motor block. This study aimed to compare the afore mentioned blocks and determine which one yielded the lowest NRS score.

Detailed Description
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This single-center, retrospective investigation was conducted at ASST Nord Milano Bassini hospital. The study was approved by the ethics committee Comitato Etico Milano Area 3. The main outcome of the study was the comparison of postoperative pain at 6, 12 and 24 hours, expressed as NRS (numeric rating scale), between PENG and LCFN . Secondary outcomes included total opioid consumption expressed as milligrams of morphine equivalents (MME), time to first opioid request, time to first postoperative ambulation.

Official Title
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Pericapsular Nerve Group (PENG) Block and Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca (FIC) Block for Multimodal Analgesia After Total Hip Replacement Surgery: a Retrospective Analysis

Conditions
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Regional Anesthesia Morbidity, Arthropathy of Hip, Hip Arthropathy

Intervention / Treatment
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* Procedure: Peripheral nerve blocks


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: elective total hip replacement surgery for non-traumatic hip disease, age >18 years, complete clinical chart included the type of peripheral nerve block performed, signed consent form for spinal anesthesia and peripheral nerve block. Exclusion Criteria: incomplete chart, a peripheral nerve block other than PENG or FIC block was performed

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PENG + LFCN Block<br>group in which PENG + LFCN Block was performed | Procedure: Peripheral nerve blocks<br>* Peripheral nerve blocks provide intense, site-specific analgesia administring local anesthetics near the nerves.<br>|
| FIC Block<br>group in which FIC Block was performed | Procedure: Peripheral nerve blocks<br>* Peripheral nerve blocks provide intense, site-specific analgesia administring local anesthetics near the nerves.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain control | pain assessment with Numeric Rating Scale (NRS): a 0-10 scale, with zero meaning no pain and 10 meaning the worst pain imaginable | 6 hours after surgery | 
| pain control | pain assessment with Numeric Rating Scale (NRS): a 0-10 scale, with zero meaning no pain and 10 meaning the worst pain imaginable | 12 hours after surgery | 
| pain control | pain assessment with Numeric Rating Scale (NRS): a 0-10 scale, with zero meaning no pain and 10 meaning the worst pain imaginable | 24 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MME of PRN opioid doses | we studied the effect of Regional anesthesia on opioid-sparing | 6 hours after surgery | 
| MME of PRN opioid doses | we studied the effect of Regional anesthesia on opioid-sparing | 12 hours after surgery | 
| Morphine Milligram Equivalents (MME) of pro re nata (PRN) opioid doses | we studied the effect of Regional anesthesia on opioid-sparing | 24 hours after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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total hip replacement surgery, primary hip arthritis