Clinical trial NCT06989047: Ultrasound-Guided PENG Block vs Femoral Nerve Block for Analgesia Before Spinal Anesthesia in Hip Fracture Surgery
Official title: Comparative Study of Preoperative Ultrasound-Guided Pericapsular Nerve Group Block and Femoral Nerve Block for Analgesia Before Spinal Anesthesia in Proximal Femur Fracture Fixation
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Proximal Femur Fracture
Hip Fracture
Pain Management
Spinal Anesthesia
Keywords: Pericapsular Nerve Group Block (PENG)
Femoral Nerve Block (FNB)
Ultrasound-Guided Nerve Block
Spinal Anesthesia
Hip Surgery
Regional Anesthesia
Lead sponsor: Ain Shams University
Sponsor class: OTHER
First posted: 2025-05-25
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study will compare two types of ultrasound-guided nerve blocks-Pericapsular Nerve Group (PENG) block and Femoral Nerve Block (FNB)-to evaluate their effectiveness in reducing pain before spinal anesthesia in patients who will undergo surgery for proximal femur fractures. Proximal femur fractures will continue to be common, especially in older adults, and often will cause severe pain that will make it difficult to position patients for spinal anesthesia. Both nerve blocks will aim to reduce pain, improve comfort during spinal anesthesia, and decrease the need for postoperative pain medication.

A total of 60 adult patients who will undergo proximal femur fracture fixation under spinal anesthesia will be enrolled and randomly assigned to receive either a Pericapsular Nerve Group (PENG) block or a femoral nerve block before the procedure. The study will monitor patients' pain scores using the Visual Analog Scale (VAS) at multiple time points, including during positioning and throughout the first 24 hours after surgery. It also will evaluate how long it will take before the patients require rescue pain medication, and how much total pain medication will be needed.


Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 years
* Scheduled for proximal femur fracture fixation under spinal anesthesia
* Classified as American Society of Anesthesiologists (ASA) physical status I, II, or III
* Ability to understand and use the Visual Analog Scale (VAS)
* Provided written informed consent

Exclusion Criteria:

* Coagulopathy
* Local infection at the injection site
* Known allergy to local anesthetics or magnesium sulfate
* Severe cardiopulmonary disease \[American Society of Anesthesiologists (ASA) ≥ IV\]
* Preexisting diabetic or other neuropathies
* Chronic opioid use
* Contraindication to spinal anesthesia
* Cognitive impairment or inability to comprehend Visual Analog Scale (VAS)

Primary outcomes:
measure: Pain Score During Positioning for Spinal Anesthesia Using Visual Analog Scale (VAS)
timeFrame: Immediately before spinal anesthesia (within 15 minutes post-block)
measure: Time to First Rescue Analgesia
timeFrame: Within 24 hours postoperatively
Secondary outcomes:
measure: Total Nalbuphine Consumption
timeFrame: 24 hours postoperatively
measure: Mean Arterial Pressure (MAP) Changes
timeFrame: From baseline up to 24 hours postoperatively
measure: Patient Satisfaction Score
timeFrame: At 24 hours postoperatively
Other outcomes:
Locations:
Study officials:
References: