Clinical trial NCT06342102: PENG and LFCN Block Versus FIC Block for Multimodal Analgesia After Total Hip Replacement Surgery: a Retrospective Analysis Focused on Movement (Retro-PvF)
Official title: 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 Focused on Movement (Retro- PvF)
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Regional Anesthesia Block
Regional Anesthesia
Total Hip Replacement Surgery
Total Hip Arthroplasty \(THA\)
Keywords: PENG
LFCN
fascia iliaca
THA
total hip replacement surgery
analgesia
movement
Peripheral nerve blocks
Lead sponsor: Ospedale Edoardo Bassini
Sponsor class: OTHER
First posted: 2024-04-02
Enrollment: 80
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Historical cohort study conducted among all patients who had THA from November 2022 to October 2023 at the ASST Nord Milano - Bassini Hospital, Cinisello Balsamo, Milano, Italy.

Brief summary: Total hip arthroplasty is a major surgical procedure performed on a growing number of patients. Optimal pain control with limited muscle weakness is paramount for a swift initiation of physical therapy and ambulation, thus expediting hospital discharge. Amongst the many peripheral nerve blocks, FIB (fascia iliaca block) has been recommended as the block of choice by many international guidelines since it offers the best pain control with a relatively low risk of motor block. PENG (pericapsular nerve group) and its association with LFCN (lateral femoral cutaneous nerve) has been proposed as an effective alternative that offers comparable, If not better, pain control with a considerably lower risk for motor block compared to FIB. Given the novelty of this block, there are few published papers on the subject, mostly case series or case reports thus justifying the need for retrospective study.

Detailed description: The primary outcome was the degree of residual quadriceps femoris muscle paresis assessed with the MRC (medical research council) scale at 6 hours between PENG and LCFN. The secondary outcomes were NRS (numeric rating scale) at 6,12, 24 hours, total opioid consumption expressed as milligrams of morphine equivalents (MME), time to first rescue opioid and time to first postoperative ambulation.

Eligibility criteria: Inclusion Criteria:

* elective total hip replacement surgery for non-traumatic hip disease,
* age over 18 years,
* complete clinical chart including type of peripheral nerve block performed,
* signed consent form for spinal anesthesia and peripheral nerve block.

Exclusion Criteria:

* preoperative opioid therapy,
* having received a peripheral nerve block other than PENG + LFCN or FICB,
* having received general anesthesia,
* incomplete chart,
* documented muscle weakness
* deviation from the established post-operative analgesia protocol.

Primary outcomes:
measure: Movement of the lower limb affected by surgery
timeFrame: 6 hours after surgery
Secondary outcomes:
measure: pain control
timeFrame: 6 hours after surgery
measure: pain control
timeFrame: 12 hours after surgery
measure: pain control
timeFrame: 24 hours after surgery
measure: Morphine Milligram Equivalents (MME) of "pro re nata" (PRN) opioid doses
timeFrame: 24 hours after surgery
measure: Morphine Milligram Equivalents (MME) of "pro re nata" (PRN) opioid doses
timeFrame: 6 hours after surgery
measure: Morphine Milligram Equivalents (MME) of "pro re nata" (PRN) opioid doses
timeFrame: 12 hours after surgery
Other outcomes:
measure: time to first opioid request
timeFrame: From date of surgery until up to 3 days after
measure: time to first postoperative ambulation
timeFrame: From date of surgery until up to 3 days after
Locations:
city: Cinisello Balsamo
country: Italy
facility: ASST Nord Milano - Ospedale E. Bassini
state: Italy/Milano
Study officials:
References: