Clinical trial NCT06577103: The Analgesic Effect of Pericapsular Nerve Group Block With Lateral Femoral Cutaneous Nerve Block and Pericapsular Nerve Group Block With Supra-inguinal Fascia Iliaca Block in Hip Hemiarthroplasty
Official title: A Comparative Study Between the Analgesic Effect of Pericapsular Nerve Group Block (PENG) With Lateral Femoral Cutaneous Nerve Block (LFCN) and Pericapsular Nerve Group Block (PENG) With Supra-inguinal Fascia Iliaca Block (SIFIC) in Hip Hemiarthroplasty: a Prospective Randomized Clinical Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Pericapsular Nerve Group Block
Lateral Femoral Cutaneous Nerve Block
Supra-inguinal Fascia Iliaca Block
Hip Hemiarthroplasty
Lead sponsor: Ain Shams University
Sponsor class: OTHER
First posted: 2024-08-29
Enrollment: 60
Sex: ALL
Minimum age (years): 40
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The aim of this study is to investigate the efficiency of preoperative and post-operative analgesia by pericapsular nerve group block (PENG) block with supra-inguinal fascia iliaca block (SIFIC) block compared with PENG block with lateral femoral cutaneous nerve block (LFCN) block in ease of giving a sitting position for spinal anesthesia and reducing narcotic consumption during the first 24 hour post-operatively and functional recovary by using the Visual analogue scale (VAS) of pain.

Detailed description: The established practice to decrease pain using opioids in hip fracture surgery may result in compromised outcomes in the frail and elderly population with nausea-vomiting, constipation, delirium and respiratory depression. This popularized the regional analgesic techniques in the surgical treatment of hip fractures. Femoral nerve (FN) and supra-inguinal fascia iliaca block (SIFIC) block are documented to provide good peri-operative analgesia with reduced need for opioids.

The latest pericapsular nerve group block (PENG) block, is an interfacial plane block targeting the articular branches of the femoral, obturator (ON) and accessory obturator nerves (AON) at the hip.

An ability to perform in supine positioning, which is especially important in patients with acute hip fractures or chronic pain is an indigenous advantage of PENG block. Due to the blockade of only sensory articular branches, substantial motor weakness is unexpected. But exclusive use of PENG block for analgesia in hip fracture patients is not sufficient as it doesn't involve the cutaneous pain-generating area supplied by the lateral femoral cutaneous nerve block (LFCN).

Eligibility criteria: Inclusion Criteria:

* Age 40-80 years.
* Sex: Both sexes.
* American Society of Anaesthesiologists (ASA) Physical Status Class I, II, and III.
* Scheduled for hip hemiarthroplasty under general anesthesia.

Exclusion Criteria:

* Declining to give a written informed consent.
* History of allergy to the medications used in the study.
* Contraindications to regional anesthesia (including patient refusal, coagulopathy and local infection).
* Psychiatric disorders or narcotic abusers.
* Significant cognitive dysfunction.
* American Society of Anesthesiologists (ASA) Physical Status Class IV.
* Renal insufficiency (to avoid local anesthetic or nalbuphine metabolites adverse effect)
* Opioid abuser patients
* Pregnancy.

Primary outcomes:
measure: Degree of pain
timeFrame: 24 hours postoperatively
Secondary outcomes:
measure: The ease of giving a sitting position for spinal anesthesia (EOSP)
timeFrame: Intraoperatively
measure: The total dose of nalbuphine consumption
timeFrame: 24 hours postoperatively
measure: The number of patients who needed rescue analgesia
timeFrame: 24 hours postoperatively
measure: Ablility to walk with support within 24 hours
timeFrame: 24 hours postoperatively
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Ain Shams University
Study officials:
References: