Total Hip Arthroplasty, Postoperative Pain
Conditions
Brief summary
Adequate pain control after total hip arthroplasty is crucial for early ambulation and patient satisfaction. However, there is no consensus about optimal pain control after post operation. In general, the periarticular multimodal durg injection block has been done for pain control in primary total hip arthroplasty. The pericapsular nerve group (PENG) block has been recently introduced a new technique for blockade of the articular branches of the femoral, obturator and accessory obturator nerves. PENG block is possible to provide sufficient analgesia and preserve lower limb muscle strength. The investigators will compare PENG and PMDI block with isolated PMDI block in patients undergoing total hip arthroplasty.
Interventions
PROCEDUREPericapsular nerve group(PENG) block combined with periarticular multimodal drug injection (PMDI)
periarticular local anesthetic infiltration with 120 mg of ropivacaine, epinephrine 0.2 mg and 30 mg of ketorolac diluted with normal saline to a total volume of 40 mL. + PENG block with ropivacaine 40 mg and epinephrine 0.1 mg with normal saline to a total volume of 20 mL
PROCEDUREisolated periarticular multimodal drug injection (PMDI)
periarticular local anesthetic infiltration with 150 mg of ropivacaine, epinephrine 0.3 mg and 30 mg of ketorolac diluted with normal saline to a total volume of 50 mL
Sponsors
Yonsei University
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
1\. Patients aged 19 years old or older, with American Society of Anesthesiologists Physical Status 1-3, and scheduled for elective unilateral total hip arthroplasty
Exclusion criteria
1. Allergy or intolerance to any of the drugs used in the study 2. Hepatic or renal insufficiency 3. Opioid dependency 4. Coagulopathy 5. Pre-existing neurologic or anatomic deficits in the lower extremities 6. Severe psychiatric illness
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numeric rating scale pain score | at 24 hours postoperatively | Pain intensity at rest evaluated by an 11-point numeric rating scale (NRS: 0 = no pain, 10 = worst imaginable pain) at 24 hours postoperatively |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain score measured at 6 hours postoperatively and 48 hours postoperatively | Pain score measured at 6 hours postoperatively and 48 hours postoperatively | Pain intensity at rest evaluated by an 11-point numeric rating scale (NRS: 0 = no pain, 10 = worst imaginable pain) at 6 hours postoperatively and 48h postoperatively |
Countries
South Korea
Contacts
Primary ContactKwankyu Park
Outcome results
None listed