Clinical trial NCT05505604: PENG vs FICB for Hip Fracture in ED Patients
Official title: Comparison of Pericapsular Nerve Group Block (PENG) Versus Fascia Iliaca Compartment Block (FICB) for Hip Fracture Analgesia in Emergency Department Patients
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Femoral Neck Fractures
Intertrochanteric Fractures
Keywords: PENG
FICB
Fascia Iliaca Compartment Block
Pericapsular Nerve Group Block
Hip fracture
Lead sponsor: University of Virginia
Sponsor class: OTHER
First posted: 2022-08-18
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Patients will be randomized to receive either a PENG or FICB. Baseline characteristics will be collected and NRS pain scores collected preblock and at specified time points post block.
Primary purpose: SUPPORTIVE_CARE

Brief summary: Regional anesthesia for hip fractures has been shown to decrease rates of delirium in elderly patients with hip fractures as well as improve pain compared to systemic opioids. The Pericapsular Nerve Group (PENG) block has recently received attention as an alternative approach to femoral nerve block and Fascia Iliaca Compartment Block (FICB). The investigators seek to evaluate if there is a difference between the PENG and FICB in terms of efficacy of pain control in ED patients presenting with hip fracture. We hypothesize that the PENG block may be superior based on previous research.

Detailed description: Fractures of the proximal femur are a common presentation to the emergency department and are an acutely painful condition. This condition predominantly affects elderly patients who are at risk for delirium and more susceptible to the adverse effects of systemic opioids. Regional anesthesia is an recommended component of pain control for elderly patients with hip fracture. The investigators seek to compare the efficacy of pain control of the Pericapsular Nerve Group (PENG) block with the Fascia Iliaca Compartment Block (FICB).

Previous studies have suggested that the PENG block may be superior to the FICB for pain control and results in less thigh motor weakness. The investigators will compare pain control (by difference in mean VAS score at set time points), systemic opioid use (in mean morphine equivalents prior to surgery), and motor function in patients with hip fractures who receive either block in the ED.

Eligibility criteria: Inclusion Criteria:

* Proximal femur fracture

Exclusion Criteria:

* refusal to consent
* hemodynamic instability
* allergy to local anesthetics
* severe injury with instability
* severe medical conditions with instability

Primary outcomes:
measure: Pain score
timeFrame: 6 hours
Secondary outcomes:
measure: Opioid use
timeFrame: From block administration until time of surgery or 24 hours if surgery performed >24 hours
Other outcomes:
Locations:
city: Charlottesville
country: United States
facility: University of Virginia Medical Center
state: Virginia
Study officials:
References:
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