Clinical trial NCT05003544: Comparıson Of PENG Block wıth Intra-articular And Quadratus Lumborum Block İn Primary Total Hip Arthroplasty
Official title: Comparıson Of PENG Block wıth Intra-articular And Quadratus Lumborum Block İn Primary Total Hip Arthroplasty: : Randomized Controlled Double Blinded Trial Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hip Arthropathy
Keywords: PENG block
intra-artikuler
Quadrotus lumborum block
Hip Arthropathy
Lead sponsor: Karaman Training and Research Hospital
Sponsor class: OTHER
First posted: 2021-08-12
Enrollment: 89
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: 90 patients ASA I-III, undergoing Total hip arthroplasty (THA) under spinal anesthesia, will be randomly assigned into one of three groups, namely group A (n=30), where an PENG block, group B (N:30) where an inra-articuler, and group C (n=30) where Quadratus lumborum block will be performed preoperatively. All patients will receive a standardized postoperative analgesia regimen. NRS scores will be evaluated in static and dynamic conditions during the first 48 hours postoperatively.

Detailed description: Total hip arthroplasty (THA) is the second most common joint replacement surgery, partly due to the aging population. The primary aim of this study is to compare the analgesic efficacy of Pericapsular nerve group (PENG) block with intra-articular and Quadrotus lumborum block (QLB). Regional anesthesia (RA), such as the recently described pericapsular nerve group (PENG) block, may provide additional analgesic benefit in this situation. Pericapsular nerve group (PENG) block is a new regional anesthesia technique to provide analgesia after hip fractures and hip arthroplasty. The aim of this single-center, double-blind, randomized controlled trial is to confirm the efficacy of PENG block for postoperative recovery after primary THA.

Routine multimodal analgesia will be used for postoperative analgesia

Eligibility criteria: Inclusion Criteria:

* Physical status according to American Society of Anesthesiologists (ASA ) I-III

Exclusion Criteria:

* Previous operation on the same hip
* Hepatic or renal insufficiency
* Younger than 18 years old and older than 85
* Patients undergoing general anesthesia
* Allergy or intolerance to one of the study medications
* BMI \>40
* ASA IV
* Chronic gabapentin/pregabalin use ( regular use for longer than 3 months)
* Chronic opioid use ( taking opioids for longer than 3 months, or daily oral morphine equivalent of \>5 mg/day one month

Primary outcomes:
measure: Numerical Rating Scale (NRS) scores
timeFrame: 48 Hours
Secondary outcomes:
measure: Opioid consumption
timeFrame: 3-6-8-12-24 and 48 hours
measure: Static and dynamic pain
timeFrame: 3-6-8-12-24 and 48 hours
measure: Presence of quadriceps motor block (defined as paralysis or paresis )
timeFrame: 3-6-12-24 hours after the block
measure: Hip adduction strength
timeFrame: 3-6-12-24 hours after the block
measure: Presence of postoperative nausea, vomiting, pruritus, urinary retention, respiratory depression
timeFrame: 3-6-12-24 hours after the block
measure: Patient satisfaction
timeFrame: 48 hours
measure: Quality of Recovery (QoR-40) score
timeFrame: measurements are obtained at 24 hours, 48 hours, and one week
measure: Mobilization time
timeFrame: 24 hour
Other outcomes:
Locations:
city: Karaman
country: Turkey
facility: Tayfun Et
Study officials:
References:
citation: Adhikary SD, Short AJ, El-Boghdadly K, Abdelmalak MJ, Chin KJ. Transmuscular quadratus lumborum versus lumbar plexus block for total hip arthroplasty: A retrospective propensity score matched cohort study. J Anaesthesiol Clin Pharmacol. 2018 Jul-Sep;34(3):372-378. doi: 10.4103/joacp.JOACP_335_17.