Hip Fractures, Regional Anesthesia
Conditions
Keywords
pericapsular nerve group block, fascia iliaca compartment block, hip fracture, regional anesthesia, dynamic pain
Brief summary
Fascia iliaca compartment block (FICB) has been considered the block of choice for patients with hip fracture. However, pericapsular nerve group (PENG) block, one of the relatively newly-developed blocks, could be also used for analgesia in patients with hip fracture. Since PENG block could block the accessory obturator nerve, PENG block might have greater analgesic effects compared to FICB theoretically. However, the comparison of these two blocks in patients with hip fracture has not performed in clinical setting. Thus, we aimed to compare the analgesic effect of PENG block and FICB.
Interventions
PROCEDUREPericapsular nerve group (PENG) block
ultrasound-guided PENG block with 0.3% ropivacaine 20cc
ultrasound-guided suprainguinal FICB with 0.3% ropivacaine 30cc
Sponsors
Asan Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ASA PS 1-4 * age: ≥19 * baseline pain score (associated with hip fracture): ≥4
Exclusion criteria
* patients who do not agree to participate in this study * patients with uncontrolled hypertension, hyperthyroidism, severe dementia * allergic to ropivacaine * contraindicated to spinal anesthesia due to coagulopathy, severe aortic stenosis/mitral stenosis, or active infection on lumbar region * patients who are considered ineligible with any other reason by investigators
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of each block (Pain score) | before surgery | We will assess the dynamic pain (pain during a movement) using NRS before and 20-30min after applying the assigned block. Then, we will calculate the change of NRS at the two time-points. NRS: Numerical rating scale (0, no pain; 10, the worst pain imaginable) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change of heart rate | before surgery | We will evaluate the heart rate before and 20-30 min after applying the assigned block. Then, we will calculate the change of heart rate at the two time-points. |
| change of blood pressure (systolic, diastolic, mean blood pressure) | before surgery | We will evaluate the blood pressure before and 20-30min after applying the assigned block. Then, we will calculate the change of blood pressure at the two time-points. |
| postoperative pain score | postoperative 6, 24, 48hours | resting and dynamic pain using NRS at postoperative 6, 24, 48hours NRS: Numerical rating scale (0, no pain; 10, the worst pain imaginable) |
| postoperative opioid consumption | postoperative 24, 48hours | morphine-equivalent dose |
| postoperative motor function | postoperative 6, 24, 48hours | motor function of quadriceps femoris grade5: normal power grade4: movement possible against some resistance grade3: movement against gravity but not resistance grade2: movement possible if gravity eliminated grade1: flicker of contraction possible grade0: complete paralysis |
Countries
South Korea
Outcome results
None listed