Clinical trial NCT05997940: Effectiveness Of The Pericapsular Nerve Group (PENG) Block In Hip Surgery
Official title: Evaluation Of The Postoperative Analgesic Effectiveness Of The Pericapsular Nerve Group Block Performed Before Spinal Anesthesia In Hip Surgery
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: PENG Block
Keywords: Pericapsular nerve group (PENG) block
Postoperative analgesia
Hip Surgery
Regional anesthesia
Spinal anesthesia
Lead sponsor: Aydin Adnan Menderes University
Sponsor class: OTHER
First posted: 2023-08-18
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: PREVENTION

Brief summary: The target population of hip surgery is usually the elderly patients with systemic comorbidity. Especially hip fractures are common in society and cause high morbidity and mortality for geriatric patients . Pain felt before and during surgery can cause metabolic and endocrine changes in the body, leading to sleep disorders, depression, delirium, dementia and persistent chronic pain. With effective postoperative analgesia, it is possible to reduce postoperative complications and mortality and accelerate post-surgical recovery. Pharmacological methods such as opioids and NSAIDs used for this may cause further deterioration and other side effects in geriatric patients with reduced renal and hepatic function, thus delaying post-surgical recovery and thus discharge. In order to avoid these side effects, regional anesthesia techniques can be preferred.

Regional anesthesia techniques are among the most effective methods of postoperative analgesia. Peripheral nerve blocks are also one of the regional anesthesia methods. Peripheral nerve blocks; They are the most ideal postoperative analgesia methods because they provide effective analgesia, reduce the need for opioids and consequently their side effects, are effective in the treatment of dynamic pain and facilitate recovery.

Patients undergoing hip surgery have very severe pain and need additional postoperative analgesics. Mobilization of patients is delayed due to pain . Depending on this , thromboembolism , deep vein The risk of nosocomial infection increases due to thrombosis , wound infection and increased length of stay.

Alleviating the pain around the hip joint capsule is an effective analgesia method in hip surgeries. The anterior capsule of the hip joint is innervated by the femoral , obturator , and accessory obturator nerves . Pericapsular nerve group (PENG) block also targets these nerves. Many studies have shown that PENG block provides adequate analgesia for more than 24 hours postoperatively. PENG block is a method that is frequently used in the world and in our clinic and has a low complication rate.

In this study, the investigators aimed to show that pericapsular nerve group block performed before spinal anesthesia in hip surgeries reduces postoperative pain and decreases total opioid consumption.


Eligibility criteria: Inclusion Criteria:

* Patients with written informed consent
* Patients over 18 years old
* Patients with ASA score I-II-III
* Patients performed spinal anesthesia for surgery

Exclusion Criteria:

* Patients without written informed consent
* Patients with ASA score IV and above
* Patients who cannot be communicated
* Patients with infection at the block site
* Patients with coagulation disorders
* Patients not suitable for spinal anesthesia
* Patients with liver and kidney failure
* Patients who are allergic to the drugs used
* Patients with major complications during the operation

Primary outcomes:
measure: Numeric Rating Scale (NRS) for postoperative analgesic efficacy
timeFrame: Preoperative
measure: Numeric Rating Scale (NRS) for postoperative analgesic efficacy
timeFrame: During the spinal anesthesia
measure: Numeric Rating Scale (NRS) for postoperative analgesic efficacy
timeFrame: Postoperative 0. hour
measure: Numeric Rating Scale (NRS) for postoperative analgesic efficacy
timeFrame: Postoperative 1. hour
measure: Numeric Rating Scale (NRS) for postoperative analgesic efficacy
timeFrame: Postoperative 6. hour
measure: Numeric Rating Scale (NRS) for postoperative analgesic efficacy
timeFrame: Postoperative 12. hour
measure: Numeric Rating Scale (NRS) for postoperative analgesic efficacy
timeFrame: Postoperative 24. hour
Secondary outcomes:
measure: Amounts of postoperative analgesic consumption
timeFrame: Postoperative 24 hours
Other outcomes:
Locations:
city: Aydın
country: Turkey
facility: Adnan Menderes University Faculty of Medicine
Study officials:
References: